Methods of detecting prostate cancer

ABSTRACT

The invention described herein provides biological markers for the diagnosis, prognosis, and monitoring of prostate cancer

RELATED APPLICATION

This application is a continuation of U.S. application Ser. No. 14/773,599, filed Sep. 8, 2015, which is a national stage application of PCT/US2014/022139, filed Mar. 7, 2014, and which claims priority and benefit from U.S. Provisional Application No. 61/775,559 filed Mar. 9, 2013, the contents and disclosure of which are hereby incorporated by reference in their entirety.

INCORPORATION-BY-REFERENCE OF MATERIAL SUBMITTED ELECTRONICALLY

Incorporated by reference in its entirety herein is a computer-readable nucleotide/amino acid sequence listing submitted concurrently herewith and identified as follows: One 6,255 Byte XML file named “35387_303_ST26.XML,” created on Feb. 16, 2023.

FIELD OF THE INVENTION

This invention relates generally to using biological markers for the diagnosis, prognosis, and monitoring of prostate cancer.

BACKGROUND OF THE INVENTION

Early diagnosis of prostate cancer often increases the likelihood of successful treatment or cure of such disease. Current diagnostic methods, however, depend largely on population-derived average values obtained from healthy individuals. Personalized diagnostic methods are needed that enable the diagnosis, especially the early diagnosis, of the presence of prostate cancer in individuals who are not known to have the cancer or who have recurrent prostate cancer.

Leukocytes begin as pluripotent hematopoietic stem cells in the bone marrow and develop along either the myeloid lineage (monocytes, macrophages, neutrophils, eosinophils, and basophils) or the lymphoid lineage (T and B lymphocytes and natural killer cells). The major function of the myeloid lineage cells (e.g., neutrophils and macrophages) is the phagocytosis of infectious organisms, live unwanted damaged cells, senescent and dead cells (apoptotic and necrotic), as well as the clearing of cellular debris. Phagocytes from healthy animals do not replicate and are diploid, i.e., have a DNA content of 2n. On average, each cell contains <10 ng DNA, <20 ng RNA, and <300 ng of protein. Non-phagocytic cells are also diploid and are not involved in the internalization of dead cells or infectious organisms and have a DNA index of one.

The lifetime of various white blood cell subpopulations varies from a few days (e.g., neutrophils) to several months (e.g., macrophages). Like other cell types, leukocytes age and eventually die. During their aging process, human blood- and tissue-derived phagocytes (e.g., neutrophils) exhibit all the classic markers of programmed cell death (i.e., apoptosis), including caspase activation, pyknotic nuclei, and chromatin fragmentation. These cells also display a number of “eat-me” flags (e.g., phosphatidylserine, sugars) on the extracellular surfaces of their plasma membranes. Consequently, dying and dead cells and subcellular fragments thereof are cleared from tissues and blood by other phagocytic cells.

The prostate specific antigen is currently one of the most widely used diagnostic measures used to detect prostate cancer. However, false negatives and false negatives are common, resulting in mistreatment of patients with no prostate cancer or overtreatment of patients with non-lethal prostate cancer. Thus, improved methods for detecting prostate cancer are needed.

SUMMARY OF THE INVENTION

In one aspect, the present invention provides methods for detecting or diagnosing prostate cancer by using at least one or more markers selected from the PC-MACRO 1-100 (Table 2) and/or PC-MACRO 101-200 (Table 3) and/or PC-NEUTRO 1-100 (Table 4) and/or PC-NEUTRO 101-200 (Table 5). Levels (e.g., gene expression levels, protein expression levels, or activity levels) of the selected markers may be measured from macrophages or neutrophils, respectively, and from non-phagocytes, from a subject. Such levels then can be compared, e.g., the levels of the selected markers in the phagocytic cells and in the non-phagocytic cells to identify one or more differences between the measured levels, indicating whether the subject has prostate cancer. The identified difference(s) can also be used for assessing the risk of developing prostate cancer, prognosing prostate cancer, monitoring prostate cancer progression or regression, assessing the efficacy of a treatment for prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer.

In yet another aspect, the levels of the selected markers in the phagocytic cells may be compared to the levels of the selected markers in a control (e.g., a normal or healthy control subject, or a normal or healthy cell from the subject) to identify one or more differences between the measured levels, indicating whether the subject has prostate cancer, the prognosis of the cancer and the monitoring of the cancer. The identified difference(s) can also be used for assessing the risk of developing prostate cancer, prognosing prostate cancer, monitoring prostate cancer progression or regression, assessing the efficacy of a treatment for prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer.

Some embodiments of this invention are as follows:

-   -   1. A method for diagnosing or aiding in the diagnosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-MACRO markers in steps a) and             b),         -   wherein the identified difference indicates that the subject             has said prostate cancer.     -   2. A method for assessing the risk of developing prostate cancer         in a subject, the method comprising the steps of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-MACRO markers in steps a) and             b),         -   wherein the identified difference indicates that the subject             has a risk of developing said prostate cancer.     -   3. A method for prognosing or aiding in the prognosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-MACRO markers in steps a) and             b),         -   wherein the identified difference is indicative of the             prognosis of said prostate cancer in the subject.     -   4. A method for assessing the efficacy of a treatment for         prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells before the treatment;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells before the treatment;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-MACRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's macrophage cells             after the treatment;         -   e) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells after the treatment;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-MACRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) is indicative of the             efficacy of the treatment for said prostate cancer in the             subject.     -   5. A method for monitoring the progression or regression of         prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells at a first time point;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells at the first time point;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-MACRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's macrophage cells at             a second time point;         -   e) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells at the second time point;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-MACRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) is indicative of the             progression or regression of said prostate cancer in the             subject.     -   6. A method for identifying a compound capable of ameliorating         or treating prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-MACRO 1-200 in a population of             the subject's macrophage cells before administering the             compound to the subject;         -   b) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells before administering the compound to the subject;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-MACRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's macrophage cells             after the administration of the compound;         -   e) measuring the levels of the one or more selected PC-MACRO             markers in a population of the subject's non-phagocytic             cells after the administration of the compound;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-MACRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) indicates that the             compound is capable of ameliorating or treating said             prostate cancer in the subject.     -   7. A method for diagnosing or aiding in the diagnosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-NEUTRO markers in steps a) and             b),         -   wherein the identified difference indicates that the subject             has said prostate cancer.     -   8. A method for assessing the risk of developing prostate cancer         in a subject, the method comprising the steps of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-NEUTRO markers in steps a) and             b),         -   wherein the identified difference indicates that the subject             has a risk of developing said prostate cancer.     -   9. A method for prognosing or aiding in the prognosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells; and         -   c) identifying a difference between the measured levels of             the one or more selected PC-NEUTRO markers in steps a) and             b),         -   wherein the identified difference is indicative of the             prognosis of said prostate cancer in the subject.     -   10. A method for assessing the efficacy of a treatment for         prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells before the treatment;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells before the treatment;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             neutrophil cells after the treatment;         -   e) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells after the treatment;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) is indicative of the             efficacy of the treatment for said prostate cancer in the             subject.     -   11. A method for monitoring the progression or regression of         prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells at a first time point;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells at the first time point;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             neutrophil cells at a second time point;         -   e) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells at the second time point;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) is indicative of the             progression or regression of said prostate cancer in the             subject.     -   12. A method for identifying a compound capable of ameliorating         or treating prostate cancer in a subject comprising:         -   a) measuring the levels of one or more markers selected from             the group consisting of PC-NEUTRO 1-200 in a population of             the subject's neutrophil cells before administering the             compound to the subject;         -   b) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells before administering the compound to             the subject;         -   c) identifying a first difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             neutrophil cells after the administration of the compound;         -   e) measuring the levels of the one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells after the administration of the             compound;         -   f) identifying a second difference between the measured             levels of the one or more selected PC-NEUTRO markers in             steps d) and e); and         -   g) identifying a difference between the first difference and             the second difference,         -   wherein the difference identified in g) indicates that the             compound is capable of ameliorating or treating said             prostate cancer in the subject.     -   13. A method for diagnosing or aiding in the diagnosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells;         -   c) identifying a difference between the measured levels of             the at least one or more selected PC-MACRO markers in             steps a) and b); and         -   d) identifying a difference between the measured levels or             activities the at least one or more selected PC-NEUTRO             markers in steps a) and b);         -   wherein the differences identified in c) and d) indicate             that the subject has said prostate cancer.     -   14. A method for assessing the risk of developing prostate         cancer in a subject, the method comprising the steps of:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells;         -   c) identifying a difference between the measured levels of             the at least one or more selected PC-MACRO markers in             steps a) and b); and         -   d) identifying a difference between the measured levels of             the at least one or more selected PC-NEUTRO markers in             steps a) and b);         -   wherein the differences identified in c) and d) indicate             that the subject has a risk of developing said prostate             cancer.     -   15. A method for prognosing or aiding in the prognosis of         prostate cancer in a subject, the method comprising the steps         of:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells;         -   c) identifying a difference between the measured levels of             the at least one or more selected PC-MACRO markers in             steps a) and b); and         -   d) identifying a difference between the measured levels of             the at least one or more selected PC-NEUTRO markers in             steps a) and b);         -   wherein the differences identified in c) and d) are             indicative of the prognosis of said prostate cancer in the             subject.     -   16. A method for assessing the efficacy of a treatment for         prostate cancer in a subject comprising:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells before the             treatment, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells before the             treatment;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells before the treatment; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells before the treatment;         -   c) identifying a first difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps a) and b); and         -   identifying a second difference between the measured levels             of the at least one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the at least one or more selected             PC-MACRO marker in a population of the subject's macrophage             cells after the treatment, and         -   measuring the levels of the at least one or more selected             PC-NEUTRO marker in a population of the subject's neutrophil             cells after the treatment;         -   e) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells after the treatment; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells after the treatment;         -   f) identifying a third difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps d) and e); and         -   g) identifying a fourth difference between the measured             levels of the at least one or more selected PC-NEUTRO             markers in steps d) and e);         -   h) identifying a difference between the first and second             differences; and         -   i) identifying a difference between the third and fourth             differences,         -   wherein the differences identified in h) and i) are             indicative of the efficacy of the treatment for said             prostate cancer in the subject.     -   17. A method for monitoring the progression or regression of         prostate cancer in a subject comprising:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells at a first time             point, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells at the first             time point;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells at the first time point; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells at the first time point;         -   c) identifying a first difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps a) and b); and         -   identifying a second difference between the measured levels             of the at least one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's macrophage             cells at a second time point, and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             neutrophil cells at the second time point;         -   e) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells at the second time point; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells at the second time point;         -   f) identifying a third difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps d) and e); and         -   g) identifying a fourth difference between the measured             levels of the at least one or more selected PC-NEUTRO             markers in steps d) and e);         -   h) identifying a difference between the first and second             differences; and         -   i) identifying a difference between the third and fourth             differences,         -   wherein the differences identified in h) and i) are             indicative of the progression or regression of said prostate             cancer in the subject.     -   18. A method for identifying a compound capable of ameliorating         or treating prostate cancer in a subject comprising:         -   a) measuring the levels of at least one or more markers             selected from the group consisting of PC-MACRO 1-200 in a             population of the subject's macrophage cells before             administering the compound to the subject, and         -   measuring the levels of at least one or more markers             selected from the group consisting of PC-NEUTRO 1-200 in a             population of the subject's neutrophil cells before             administering the compound to the subject;         -   b) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells before administering the compound to             the subject; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells before administering the compound to             the subject;         -   c) identifying a first difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps a) and b); and         -   identifying a second difference between the measured levels             of the at least one or more selected PC-NEUTRO markers in             steps a) and b);         -   d) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's macrophage             cells after administering the compound to the subject, and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             neutrophil cells after administering the compound to the             subject;         -   e) measuring the levels of the at least one or more selected             PC-MACRO markers in a population of the subject's             non-phagocytic cells after administering the compound to the             subject; and         -   measuring the levels of the at least one or more selected             PC-NEUTRO markers in a population of the subject's             non-phagocytic cells after administering the compound to the             subject;         -   f) identifying a third difference between the measured             levels of the at least one or more selected PC-MACRO markers             in steps d) and e); and         -   g) identifying a fourth difference between the measured             levels of the at least one or more selected PC-NEUTRO             markers in steps d) and e);         -   h) identifying a difference between the first and second             differences; and         -   i) identifying a difference between the third and fourth             differences,         -   wherein the differences identified in h) and i) indicate             that the compound is capable of ameliorating or treating             said prostate cancer in the subject.     -   19. The method of any one of embodiments 1-18, further         comprising measuring at least one standard parameter associated         with said prostate cancer.     -   20. The method of embodiment 19, wherein the standard parameter         is selected from the group consisting of tumor stage, tumor         grade, tumor size, tumor visual characteristics, tumor growth,         tumor thickness, tumor progression, tumor metastasis tumor         distribution within the body, odor, molecular pathology,         genomics, or tumor angiograms.     -   21. The method of any one of embodiments 13-18, wherein the         selected PC-MACRO markers and the selected PC-NEUTRO markers are         measured from the same population of non-phagocytic cells in         steps b) or e).     -   22. The method of any one of embodiments 13-18, wherein the         selected PC-MACRO markers and the selected PC-NEUTRO are from         different populations of non-phagocytic cells in steps b) or e).     -   23. The method of any one of embodiments 1-6 and 13-18, wherein         at least two, three, four, or five markers are selected from         PC-MACRO 1-200.     -   24. The method of any one of embodiments 1-6 and 13-18, wherein         the selected PC-MACRO markers comprise one or more markers         selected from the group consisting of P2RY10, TNFAIP3, CXCR1,         DNAJB1, and CHI3L1.     -   25. The method of any one of embodiments 1-6 and 13-18, wherein         the selected PC-MACRO markers are up-regulated or activated in         the macrophage cells compared to the non-phagocytic cells.     -   26. The method of embodiment 1-6 and 13-18, wherein the selected         PC-MACRO markers are up-regulated or activated in the macrophage         cells compared to the non-phagocytic cells.     -   27. The method of any one of embodiments 1-6 and 13-18, wherein         the selected PC-MACRO markers are down-regulated or inhibited in         the macrophage cells compared to the non-phagocytic cells.     -   28. The method of any one of embodiments 1-6 and 13-18, wherein         the selected PC-MACRO markers are down-regulated or inhibited in         the macrophage cells compared to the non-phagocytic cells.     -   29. The method of any one of embodiments 7-18, wherein at least         two, three, four, five, six, seven, eight, nine, ten, or eleven         markers are selected from PC-NEUTRO 1-200.     -   30. The method of any one of embodiments 7-18, wherein the         selected PC-NEUTRO markers comprise one or more PC-NEUTRO         markers selected from the group consisting of EIF3S5, EEEF1A1,         RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA.     -   31. The method of any one of embodiments 7-18, wherein the         selected PC-NEUTRO markers comprise one or more markers selected         from the group consisting of PC-NEUTRO 1-200 and wherein the         selected PC-NEUTRO markers are down-regulated or inhibited in         the neutrophil cells compared to the non-phagocytic cells.     -   32. The method of any one of embodiments 7-18, wherein the         selected PC-NEUTRO markers are down-regulated or inhibited in         the neutrophil cells compared to the non-phagocytic cells.     -   33. The method of any one of embodiments 1-6 and 13-18, further         comprising lysing the macrophage cells and the non-phagocytic         cells before a).     -   34. The method of any one of embodiments 1-6 and 13-18, further         comprising extracting the cellular contents from the macrophage         cells and the non-phagocytic cells before a).     -   35. The method of any one of embodiments 7-18, further         comprising lysing the neutrophil cells and the non-phagocytic         cells before a).     -   36. The method of any one of embodiments 7-18, further         comprising extracting the cellular contents from the neutrophil         cells and the non-phagocytic cells before a).     -   37. The method of embodiment 34, wherein the cellular contents         of the macrophage cells comprise viable diseased cells, dead         diseased cells, apoptotic diseased cells, circulating tumor         cells, infectious agents, fetal cells, trophoblasts, or         fragments thereof.     -   38. The method of embodiment 36, wherein the cellular contents         of the neutrophil cells comprise viable diseased cells, dead         diseased cells, apoptotic diseased cells, circulating tumor         cells, infectious agents, fetal cells, trophoblasts, or         fragments thereof.     -   39. The method of embodiment 34, wherein the selected one or         more markers are present in the cellular contents of the         macrophage cells.     -   40. The method of embodiment 34, wherein the selected one or         more markers are not present in the cellular contents of the         non-phagocytic cells.     -   41. The method of any one of embodiments 1-6 and 13-18, wherein         the macrophage cells express the one or more selected PC-MACRO         markers.     -   42. The method of embodiment 36, wherein the selected one or         more markers are present in the cellular contents of the         neutrophil cells.     -   43. The method of embodiment 36, wherein the selected one or         more markers are not present in the cellular contents of the         non-phagocytic cells.     -   44. The method of any one of embodiments 7-18, wherein the         neutrophil cells express the one or more selected PC-NEUTRO         markers.     -   45. The method of any one of embodiments 1-18, wherein the         non-phagocytic cells are T cells, B cells, null cells,         basophils, or mixtures thereof.     -   46. The method of any one of embodiments 1-6 and 13-18, wherein         the macrophage cells are isolated from a bodily fluid sample,         tissues, or cells of the subject.     -   47. The method of any one of embodiments 7-18, wherein the         neutrophil cells are isolated from a bodily fluid sample,         tissues, or cells of the subject.     -   48. The method of any one of embodiments 1-18, wherein the         non-phagocytic cells are isolated from a bodily fluid sample,         tissues, or cells of the subject.     -   49. The method of any one of embodiments 46-48, wherein the         bodily fluid sample is blood, urine, stool, saliva, lymph fluid,         cerebrospinal fluid, synovial fluid, cystic fluid, ascites,         pleural effusion, fluid obtained from a pregnant woman in the         first trimester, fluid obtained from a pregnant woman in the         second trimester, fluid obtained from a pregnant woman in the         third trimester, maternal blood, amniotic fluid, chorionic         villus sample, fluid from a preimplantation embryo, maternal         urine, maternal saliva, placental sample, fetal blood, lavage         and cervical vaginal fluid, interstitial fluid, or ocular fluid.     -   50. The method of any one of embodiments 1-6 and 13-18, wherein         the macrophage cells are isolated using antibodies, using a         ligand that binds to a molecular receptor expressed on the         plasma membranes of white blood cells, or by flow cytometry,         fluorescence activated cell sorting, filtration, gradient-based         centrifugation, elution, microfluidics, magnetic separation         technique, fluorescent-magnetic separation technique,         nanostructure, quantum dots, high throughput microscope-based         platforms, or a combination thereof.     -   51. The method of any one of embodiments 7-18, wherein the         neutrophil cells are isolated using antibodies, using a ligand         that binds to a molecular receptor expressed on the plasma         membranes of white blood cells, or by flow cytometry,         fluorescence activated cell sorting, filtration, gradient-based         centrifugation, elution, microfluidics, magnetic separation         technique, fluorescent-magnetic separation technique,         nanostructure, quantum dots, high throughput microscope-based         platforms, or a combination thereof.     -   52. The method of any one of embodiments 1-18, wherein the         non-phagocytic cells are isolated using antibodies, using a         ligand that binds to a molecular receptor expressed on the         plasma membranes of white blood cells, or by flow cytometry,         fluorescence activated cell sorting, filtration, gradient-based         centrifugation, elution, microfluidics, magnetic separation         technique, fluorescent-magnetic separation technique,         nanostructure, quantum dots, high throughput microscope-based         platforms, or a combination thereof.     -   53. The method of any one of embodiments 1-6 and 13-18, wherein         the macrophage cells are isolated using a product secreted by         the macrophage cells.     -   54. The method of any one of embodiments 7-18, wherein the         neutrophil cells are isolated by using a product secreted by the         neutrophil cells.     -   55. The method of any one the embodiments 1-6 and 13-18, wherein         the macrophage cells are isolated by using a cell surface target         on the surface of macrophage cells.     -   56. The method of any one of embodiments 7-18, wherein the         neutrophil cells are isolated by using a cell surface target on         the surface of neutrophil cells.     -   57. The method of embodiment 55, wherein the target is expressed         by the macrophage cells.     -   58. The method of embodiment 55, wherein the target is not         expressed by the macrophage cells.     -   59. The method of embodiment 56, wherein the target is expressed         by the neutrophil cells.     -   60. The method of embodiment 56, wherein the target is not         expressed by the neutrophil cells.     -   61. The method of any one of embodiments 55-60, wherein the         target is a marker of said prostate cancer.     -   62. The method of any one of embodiments 1-18, wherein the         measured levels are gene expression levels.     -   63. The method of any one of embodiments 1-18, wherein the         measured levels are protein expression levels.     -   64. The method of any one of the embodiment 1-18, wherein the         levels or activities are measured by a qualitative assay, a         quantitative assay, or a combination thereof.     -   65. The method of embodiment 64, wherein the quantitative assay         uses sequencing, direct sequencing, RNA sequencing, whole         transcriptome shotgun sequencing, random shotgun sequencing,         Sanger dideoxy termination sequencing, whole-genome sequencing,         sequencing by hybridization, pyrosequencing, capillary         electrophoresis, gel electrophoresis, duplex sequencing, cycle         sequencing, single-base extension sequencing, solid-phase         sequencing, high-throughput sequencing, massively parallel         signature sequencing, emulsion PCR, sequencing by reversible dye         terminator, paired-end sequencing, near-term sequencing,         exonuclease sequencing, sequencing by ligation, short-read         sequencing, single-molecule sequencing, sequencing-by-synthesis,         real-time sequencing, reverse-terminator sequencing, nanopore         sequencing, 454 sequencing, Solexa Genome Analyzer sequencing,         SOLiD® sequencing, MS-PET sequencing, mass spectrometry, matrix         assisted laser desorption/ionization-time of flight (MALDI-TOF)         mass spectrometry, electrospray ionization (ESI) mass         spectrometry, surface-enhanced laser deorption/ionization-time         of flight (SELDI-TOF) mass spectrometry, quadrupole-time of         flight (Q-TOF) mass spectrometry, atmospheric pressure         photoionization mass spectrometry (APPI-MS), Fourier transform         mass spectrometry (FTMS), matrix-assisted laser         desorption/ionization-Fourier transform-ion cyclotron resonance         (MALDI-FT-ICR) mass spectrometry, secondary ion mass         spectrometry (SIMS), polymerase chain reaction (PCR) analysis,         quantitative PCR, real-time PCR, fluorescence assay,         colorimetric assay, chemiluminescent assay, or a combination         thereof.     -   66. The method of embodiment 62, wherein the gene expression         levels are measured by polymerase chain reaction (PCR) analysis,         sequencing analysis, electrophoretic analysis, restriction         fragment length polymorphism (RFLP) analysis, Northern blot         analysis, quantitative PCR, reverse-transcriptase-PCR analysis         (RT-PCR), allele-specific oligonucleotide hybridization         analysis, comparative genomic hybridization, heteroduplex         mobility assay (HMA), single strand conformational polymorphism         (SSCP), denaturing gradient gel electrophisis (DGGE), RNAase         mismatch analysis, mass spectrometry, tandem mass spectrometry,         matrix assisted laser desorption/ionization-time of flight         (MALDI-TOF) mass spectrometry, electrospray ionization (ESI)         mass spectrometry, surface-enhanced laser         deorption/ionization-time of flight (SELDI-TOF) mass         spectrometry, quadrupole-time of flight (Q-TOF) mass         spectrometry, atmospheric pressure photoionization mass         spectrometry (APPI-MS), Fourier transform mass spectrometry         (FTMS), matrix-assisted laser desorption/ionization-Fourier         transform-ion cyclotron resonance (MALDI-FT-ICR) mass         spectrometry, secondary ion mass spectrometry (SIMS), surface         plasmon resonance, Southern blot analysis, in situ         hybridization, fluorescence in situ hybridization (FISH),         chromogenic in situ hybridization (CISH), immunohistochemistry         (IHC), microarray, comparative genomic hybridization,         karyotyping, multiplex ligation-dependent probe amplification         (MLPA), Quantitative Multiplex PCR of Short Fluorescent         Fragments (QMPSF), microscopy, methylation specific PCR (MSP)         assay, HpaII tiny fragment Enrichment by Ligation-mediated PCR         (HELP) assay, radioactive acetate labeling assays, colorimetric         DNA acetylation assay, chromatin immunoprecipitation combined         with microarray (ChIP-on-chip) assay, restriction landmark         genomic scanning, Methylated DNA immunoprecipitation (MeDIP),         molecular break light assay for DNA adenine methyltransferase         activity, chromatographic separation, methylation-sensitive         restriction enzyme analysis, bisulfite-driven conversion of         non-methylated cytosine to uracil, methyl-binding PCR analysis,         or a combination thereof.     -   67. The method of embodiment 62, wherein the gene expression         levels are measured by a sequencing technique selected from the         group consisting of direct sequencing, RNA sequencing, whole         transcriptome shotgun sequencing, random shotgun sequencing,         Sanger dideoxy termination sequencing, whole-genome sequencing,         sequencing by hybridization, pyrosequencing, capillary         electrophoresis, gel electrophoresis, duplex sequencing, cycle         sequencing, single-base extension sequencing, solid-phase         sequencing, high-throughput sequencing, massively parallel         signature sequencing, emulsion PCR, sequencing by reversible dye         terminator, paired-end sequencing, near-term sequencing,         exonuclease sequencing, sequencing by ligation, short-read         sequencing, single-molecule sequencing, sequencing-by-synthesis,         real-time sequencing, reverse-terminator sequencing, nanopore         sequencing, 454 sequencing, Solexa Genome Analyzer sequencing,         SOLiD® sequencing, MS-PET sequencing, mass spectrometry, and a         combination thereof.     -   68. The method of embodiment 63, wherein the protein expression         levels are measured by an immunohistochemistry assay, an         enzyme-linked immunosorbent assay (ELISA), in situ         hybridization, chromatography, liquid chromatography, size         exclusion chromatography, high performance liquid chromatography         (HPLC), gas chromatography, mass spectrometry, tandem mass         spectrometry, matrix assisted laser desorption/ionization-time         of flight (MALDI-TOF) mass spectrometry, electrospray ionization         (ESI) mass spectrometry, surface-enhanced laser         deorption/ionization-time of flight (SELDI-TOF) mass         spectrometry, quadrupole-time of flight (Q-TOF) mass         spectrometry, atmospheric pressure photoionization mass         spectrometry (APPI-MS), Fourier transform mass spectrometry         (FTMS), matrix-assisted laser desorption/ionization-Fourier         transform-ion cyclotron resonance (MALDI-FT-ICR) mass         spectrometry, secondary ion mass spectrometry (SIMS),         radioimmunoassays, microscopy, microfluidic chip-based assays,         surface plasmon resonance, sequencing, Western blotting assay,         or a combination thereof.     -   69. The method of any one the embodiments 1-68, wherein the         subject is a mammal.     -   70. The method of embodiment 69, wherein the subject is a human     -   71. The method of any one the embodiments 1-18, wherein the         difference is greater than a 1-fold difference.     -   72. The method of embodiment 71, wherein the difference is at         least 1.05-fold, 1.1-fold, 1.2-fold, 1.3-fold, 1.4-fold,         1.5-fold, 2-fold, 2.5-fold, 3-fold, 4-fold, 5-fold, 6-fold,         7-fold, 8-fold, 9-fold, or 10-fold difference.     -   73. A kit for measuring the levels of at least one or more         markers selected from the group consisting of PC-MACRO 1-200,         comprising reagents for specifically measuring the levels of the         selected PC-MACRO marker.     -   74. A kit for measuring the levels of at least one or more         markers selected from the group consisting of PC-NEUTRO 1-200,         comprising reagents for specifically measuring the levels of the         selected PC-NEUTRO marker.     -   75. A kit for measuring the levels of at least one or more         markers selected from the group consisting of PC-MACRO 1-200 and         at least one or more markers selected from the group consisting         of PC-NEUTRO 1-200, comprising reagents for specifically         measuring the levels of the selected PC-MACRO marker and         reagents for specifically measuring the levels of the selected         PC-NEUTRO marker.     -   76. The kit of embodiment 73 or 75, wherein the selected         PC-MACRO markers comprise one or more markers selected from the         group consisting of P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1.     -   77. The kit of embodiment 74 or 75, wherein the selected         PC-NEUTRO markers comprise one or more markers selected from the         group consisting of EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A,         RPL3, RPS28, and PTMA.     -   78. The kit of any one of embodiments 73-77, wherein the         reagents comprise one or more antibodies or fragments thereof,         oligonucleotides, or aptamers.     -   79. A method of treating or preventing prostate cancer in a         subject comprising administering to said subject an agent that         modulates the activity or expression of at least one or more         markers selected from the group consisting of PC-MACRO 1-200.     -   80. A method of treating or preventing prostate cancer in a         subject comprising administering to said subject an agent that         modulates the activity or expression of at least one or more         markers selected from the group consisting of PC-NEUTRO 1-200.     -   81. The method of embodiment 79 or 80, wherein the agent is a         small molecule modulator, siRNA, or an antibody or fragment         thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts a diagram of a 3-fold cross validation method.

FIG. 2 depicts exemplary prostate cancer genes identified from macrophages. M, macrophage; TC, T cell; DE, differential expression.

FIG. 3 depicts the selection of a prostate cancer marker from among potential markers analyzed in macrophages vs. T cells.

FIG. 4 depicts genetic signature for prostate cancer markers form macrophages in head and neck cancer patients.

FIG. 5 depicts a summary of prostate cancer markers identified from macrophage vs. T cell and neutrophil vs. T cell comparisons in prostate cancer patients.

FIG. 6 depicts genetic signature for prostate cancer markers from neutrophils in head and neck cancer patients.

FIG. 7 depicts a comparison of cancer detection using markers identified from macrophages and neutrophils vs. T cells, as compared to detection when the phagocyte gene expression is not compared to T cell gene expression.

FIG. 8 depicts a purification method for validating methods of detecting prostate cancer.

FIG. 9 depicts a comparison of purification methods in validating a method of detecting prostate cancer.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides biological markers and methods of using them to detect a cancer. More specifically, the present invention provides biomarkers that are specific for prostate cancer.

As used here in, a “biomarker” or “marker” refers to an analyte (e.g., a nucleic acid, DNA, RNA, peptide, protein, or metabolite) that can be objectively measured and evaluated as an indicator for a biological process. In some embodiments, a marker is differentially detectable in phagocytes and is indicative of the presence or absence of prostate cancer. An analyte is differentially detectable if it can be distinguished quantitatively or qualitatively in phagocytes compared to a control, e.g., a normal or healthy control or non-phagocytic cells.

The present invention is based on the discovery that one or more markers selected from Tables 2 and 3 (PC-MACRO markers) or Tables 4 and 5 (PC-NEUTRO markers) are useful in diagnosing prostate cancer. By measuring the levels of the biomarkers (e.g., gene expression levels, protein expression levels, or protein activity levels) in a population of phagocytes (e.g., macrophage or neutrophils) from a human subject, one can provide a reliable diagnosis for prostate cancer.

As used herein, a “level” of a marker of this invention can be qualitative (e.g., presence or absence) or quantitative (e.g., amounts, copy numbers, or dosages). In some embodiments, a level of a marker at a zero value can indicate the absence of this marker. The levels of any marker of this invention can be measured in various forms. For example, the level can be a gene expression level, a RNA transcript level, a protein expression level, a protein activity level, an enzymatic activity level.

The markers of this invention can be used in methods for diagnosing or aiding in the diagnosis of prostate cancer by comparing levels (e.g., gene expression levels, or protein expression levels, or protein activities) of one or more prostate cancer markers (e.g., nucleic acids or proteins) between phagocytes (e.g., macrophages or neutrophils) and non-phagocytic cells taken from the same individual. This invention also provides methods for assessing the risk of developing prostate cancer, prognosing said cancer, monitoring said cancer progression or regression, assessing the efficacy of a treatment, or identifying a compound capable of ameliorating or treating said cancer.

The methods of this invention can be applied to prostate cancer. As used herein, “prostate cancer” means any cancer of the prostate including, but not limited to, adenocarcinoma and small cell carcinoma.

In a first aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 2 and 3 (PC-MACRO markers) in a population of a subject's macrophage cells; b) measuring the levels of one or more of the selected markers in a population of a subject's non-phagocytic cells (e.g., T-cells, B-cells, null cells, basophils or the mixtures of two more non-phagocytic cells); comparing the measured levels in step a) to the measured levels in step b) and further identify a difference between the measured levels of a) and b). The identified difference is indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In a second aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 2 and 3 (PC-MACRO markers) in a population of a subject's macrophage cells; identifying a difference between the measured levels of the selected markers in step a) and the levels of the selected markers in a control (e.g., a healthy control cell, or a control cell from a healthy subject). The identified difference is indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In the first and second aspects, the selected markers comprise one or more (e.g., two, three, four, or five) of PC-MACRO Markers 1-4 and 105, i.e., P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1. In some embodiments, the selected markers are up-regulated (see Tables 2 and/or 3 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 2 and/or 3 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one PC-MACRO Marker that is up-regulated and at least one PC-MACRO Marker that is down-regulated. In some embodiments, the selected markers consist of P2RY10, TNFAIP3, CXCR1, and DNAJB1 or of P2RY10, TNFAIP3, CXCR1, CHI3L1 and DNAJB1.

In a third aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 4 and 5 (PC-NEUTRO Markers) in a population of a subject's neutrophil cells; b) measuring the levels of one or more of the selected markers in a population of a subject's non-phagocytic cells (e.g., T-cells, B-cells, null cells, basophils or the mixtures of two more non-phagocytic cells); comparing the measured levels in step a) to the measured levels in step b) and further identify a difference between the measured levels of a) and b). The identified difference is indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In a fourth aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 4 and 5 (PC-NEUTRO Markers) in a population of a subject's neutrophil cells; identifying a difference between the measured levels of the selected markers in step a) and the levels of the selected markers in a control (e.g., a healthy control cell, or a control cell from a healthy subject). The identified difference is indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In the third and fourth aspects, the selected markers comprise one or more (e.g., two, three, four, five, six, seven, eight, nine, ten, or eleven) PC-NEUTRO Markers 1-11, e.g., EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA). In some embodiments, the selected markers are up-regulated (see Tables 4 and 5 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 4 and 5 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one PC-NEUTRO Marker that is up-regulated and at least one PC-NEUTRO Marker that is down-regulated. In some embodiments, the selected markers consist of EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA.

In a fifth aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 4 and 5 (PC-NEUTRO markers) in a population of a subject's neutrophil cells and the levels of one or more markers selected from Tables 2 and 3 (PC-MACRO markers) in a population of a subject's macrophage cells; b) measuring the levels of one or more of the selected PC-MACRO markers and the levels one or more of the selected PC-NEUTRO markers in a population of a subject's non-phagocytic cells (e.g., T-cells, B-cells, null cells, basophils or the mixtures of two more non-phagocytic cells); identifying a difference between the measured levels of the selected PC-NEUTRO markers of steps a) and b) and identifying a difference between the measured levels of the selected PC-MACRO markers of steps a) and b). The identified differences are indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In a sixth aspect, the methods (e.g., diagnosis of prostate cancer, prognosis of prostate cancer, or assessing the risk of developing prostate cancer) provided in the invention comprise: a) measuring the levels of one or more markers selected from Tables 4 and 5 (PC-NEUTRO markers) in a population of a subject's neutrophil cells and the levels of one or more markers selected from Tables 2 and 3 (PC-MACRO markers) in a population of a subject's macrophage cells; identifying a difference between the measured levels of the selected PC-NEUTRO markers of steps a) and the levels of the selected PC-NEUTRO markers in a control (e.g., a healthy control cell, or a control cell from a healthy subject) and identifying a difference between the measured levels of the selected PC-MACRO markers of step a) and the levels of the selected PC-MACRO markers in a control (e.g., a healthy control cell, or a control cell from a healthy subject). The identified differences are indicative of the diagnosis (e.g., presence or absence), prognosis (e.g., lethal outcome, or tumor stage), or the risk of developing prostate cancer.

In the fifth and sixth aspects, the selected PC-NEUTRO markers comprise one or more (e.g., two, three, four, five, six, seven, eight, nine, ten, or eleven) PC-NEUTRO Markers 1-11, e.g., EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA and the selected PC-MACRO markers comprise one or more (e.g., two, three, four, or five) PC-MACRO Markers 1-4 and 105, i.e., P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1. In some embodiments, the selected markers are up-regulated (see Tables 2-5 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 2-5 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one marker (PC-MACRO or PC-NEUTRO marker) that is up-regulated and at least one marker (PC-MACRO or PC-NEUTRO marker) that is down-regulated. In some embodiments, the selected markers consist of EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, PTMA, P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1.

In a seventh aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising: a) measuring the levels of one or more markers selected from the group consisting of PC-MACRO 1-200 (Tables 2 and 3) in a population of the subject's macrophage cells before the treatment, or at a first time point, or before administration of the compound, respectively; b) measuring the levels of the one or more selected PC-MACRO markers in a population of the subject's non-phagocytic cells before the treatment, or at the first time point, or before administration of the compound, respectively; c) identifying a first difference between the measured levels of the one or more selected PC-MACRO markers in steps a) and b); d) measuring the levels of the one or more selected PC-MACRO markers in a population of the subject's macrophage cells after the treatment, or at a second time point, or after administration of the compound, respectively; e) measuring the levels of the one or more selected PC-MACRO markers in a population of the subject's non-phagocytic cells after the treatment, or at the second time point, or after administration of the compound, respectively; f) identifying a second difference between the measured levels of the one or more selected PC-MACRO markers in steps d) and e); and g) identifying a difference between the first difference and the second difference, wherein the difference identified in g) is indicative of the efficacy of the treatment for the prostate cancer, or the progression or regression of the prostate cancer, or whether the compound is capable of ameliorating or treating the prostate cancer, respectively, in the subject.

In a eighth aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising: a) measuring the levels of one or more markers selected from the group consisting of PC-MACRO 1-200 (Tables 2 and 3) in a population of the subject's macrophage cells before the treatment, or at a first time point, or before administration of the compound, respectively; b) identifying a first difference between the measured levels of the one or more selected PC-MACRO markers in step (a) and the levels of the one or more selected PC-MACRO markers in a control (e.g., a healthy control cell, or a control cell from a healthy subject) before the treatment, or at the first time point, or before administration of the compound, respectively; c) measuring the levels of the one or more selected PC-MACRO markers in a population of the subject's macrophage cells after the treatment, or at a second time point, or after administration of the compound, respectively; d) identifying a second difference between the measured levels of the one or more selected PC-MACRO markers in step c) and the levels of the one or more selected PC-MACRO markers in a control after the treatment, or at the second time point, or after administration of the compound, respectively; and e) identifying a difference between the first difference and the second difference, wherein the difference identified in e) is indicative of the efficacy of the treatment for the prostate cancer, or the progression or regression of the prostate cancer, or whether the compound is capable of ameliorating or treating the prostate cancer, respectively, in the subject.

In the seventh and eighth aspects, the selected markers comprise one or more (e.g., two, three, four, or five) PC-MACRO Markers 1-4 and 105, i.e., P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1. In some embodiments, the selected markers are up-regulated (see Tables 2 and 3 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 2 and 3 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one PC-MACRO Marker that is up-regulated and at least one PC-MACRO Marker that is down-regulated. In some embodiments, the selected markers consist of P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1

In a ninth aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising: a) measuring the levels of one or more markers selected from the group consisting of PC-NEUTRO 1-200 (Table 4 and 5) in a population of the subject's neutrophil cells before the treatment, or at a first time point, or before administration of the compound, respectively; b) measuring the levels of the one or more selected PC-NEUTRO markers in a population of the subject's non-phagocytic cells before the treatment, or at the first time point, or before administration of the compound, respectively; c) identifying a first difference between the measured levels of the one or more selected PC-NEUTRO markers in steps a) and b); d) measuring the levels of the one or more selected PC-NEUTRO markers in a population of the subject's neutrophil cells after the treatment, or at a second time point, or after administration of the compound, respectively; e) measuring the levels of the one or more selected PC-NEUTRO markers in a population of the subject's non-phagocytic cells after the treatment, or at the second time point, or after administration of the compound, respectively; f) identifying a second difference between the measured levels of the one or more selected PC-NEUTRO markers in steps d) and e); and g) identifying a difference between the first difference and the second difference, wherein the difference identified in g) is indicative of the efficacy of the treatment for the prostate cancer, or the progression or regression of the prostate cancer, or whether the compound is capable of ameliorating or treating the prostate cancer, respectively, in the subject.

In a tenth aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising: a) measuring the levels of one or more markers selected from the group consisting of PC-NEUTRO 1-200 (Tables 4 and 5) in a population of the subject's neutrophil cells before the treatment, or at a first time point, or before administration of the compound, respectively; b) identifying a first difference between the measured levels of the one or more selected PC-NEUTRO markers in step (a) and the levels of the one or more selected PC-NEUTRO markers in a control (e.g., a control cell from a healthy subject, or a normal or healthy cell from the subject) before the treatment, or at the first time point, or before administration of the compound, respectively; c) measuring the levels of the one or more selected PC-NEUTRO markers in a population of the subject's neutrophil cells after the treatment, or at a second time point, or after administration of the compound, respectively; d) identifying a second difference between the measured levels of the one or more selected PC-NEUTRO markers in step c) and the levels of the one or more selected PC-NEUTRO markers in a control after the treatment, or at the second time point, or after administration of the compound, respectively; and e) identifying a difference between the first difference and the second difference, wherein the difference identified in e) is indicative of the efficacy of the treatment for the prostate cancer, or the progression or regression of the prostate cancer, or whether the compound is capable of ameliorating or treating the prostate cancer, respectively, in the subject.

In the ninth and tenth aspects, the selected markers comprise one or more (e.g., two, three, four, five, six, seven, eight, nine, ten, or 11) PC-NEUTRO Markers 1-11, e.g., EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA. In some embodiments, the selected markers are up-regulated (see Tables 4 and 5 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 4 and 5 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one PC-NEUTRO Marker that is up-regulated and at least one PC-NEUTRO Marker that is down-regulated. In some embodiments, the selected markers consist of EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA.

In an eleventh aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising:

-   -   a) measuring the levels of at least one or more markers selected         from the group consisting of PC-MACRO 1-200 in a population of         the subject's macrophage cells before the treatment, at a first         time point, or before administration of the compound,         respectively, and     -   measuring the levels of at least one or more markers selected         from the group consisting of PC-NEUTRO 1-200 in a population of         the subject's neutrophil cells before the treatment, at the         first time point, or before administration of the compound,         respectively;     -   b) measuring the levels of the at least one or more selected         PC-MACRO markers in a population of the subject's non-phagocytic         cells before the treatment, at the first time point, or before         administration of the compound, respectively; and     -   measuring the levels of the at least one or more selected         PC-NEUTRO markers in a population of the subject's         non-phagocytic cells before the treatment, at the first time         point, or before administration of the compound, respectively;     -   c) identifying a first difference between the measured levels of         the at least one or more selected PC-MACRO markers in steps a)         and b); and     -   identifying a second difference between the measured levels of         the at least one or more selected PC-NEUTRO markers in steps a)         and b);     -   d) measuring the levels of the at least one or more selected         PC-MACRO marker in a population of the subject's macrophage         cells after the treatment, at a second time point, or after         administration of the compound, respectively, and     -   measuring the levels of the at least one or more selected         PC-NEUTRO marker in a population of the subject's neutrophil         cells after the treatment, at the second time point, or after         administration of the compound, respectively;     -   e) measuring the levels of the at least one or more selected         PC-MACRO markers in a population of the subject's non-phagocytic         cells after the treatment, at the second time point, or after         administration of the compound, respectively; and     -   measuring the levels of the at least one or more selected         PC-NEUTRO markers in a population of the subject's         non-phagocytic cells after the treatment, at the second time         point, or after administration of the compound, respectively;     -   f) identifying a third difference between the measured levels of         the at least one or more selected PC-MACRO markers in steps d)         and e); and     -   g) identifying a fourth difference between the measured levels         of the at least one or more selected PC-NEUTRO markers in         steps d) and e);     -   h) identifying a difference between the first and second         differences; and     -   i) identifying a difference between the third and fourth         differences,     -   wherein the differences identified in h) and i) are indicative         of the efficacy of the treatment for the prostate cancer, or the         progression or regression of the prostate cancer, or whether the         compound is capable of ameliorating or treating the prostate         cancer, respectively, in the subject.

In an twelfth aspect, the methods provided in this invention for assessing the efficacy of a treatment for prostate cancer, monitoring the progression or regression of prostate cancer, or identifying a compound capable of ameliorating or treating prostate cancer, respectively, in a subject comprising:

-   -   a) measuring the levels of at least one or more markers selected         from the group consisting of PC-MACRO 1-200 in a population of         the subject's macrophage cells before the treatment, at a first         time point, or before administration of the compound,         respectively, and     -   measuring the levels of at least one or more markers selected         from the group consisting of PC-NEUTRO 1-200 in a population of         the subject's neutrophil cells before the treatment, at the         first time point, or before administration of the compound,         respectively;     -   b) identifying a first difference between the measured levels of         the at least one or more selected PC-MACRO markers in steps a)         and the levels of the at least one or more selected PC-MACRO         markers in a control before the treatment, at the first time         point, or before administration of the compound, respectively;         and     -   identifying a second difference between the measured levels of         the at least one or more selected PC-NEUTRO markers in steps a)         and the levels of the at least one or more selected PC-NEUTRO         markers in a control before the treatment, at the first time         point, or before administration of the compound, respectively;     -   c) measuring the levels of the at least one or more selected         PC-MACRO marker in a population of the subject's macrophage         cells after the treatment, at a second time point, or after         administration of the compound, respectively, and     -   measuring the levels of the at least one or more selected         PC-NEUTRO marker in a population of the subject's neutrophil         cells after the treatment, at the second time point, or after         administration of the compound, respectively;     -   d) identifying a third difference between the measured levels of         the at least one or more selected PC-MACRO markers in steps c)         and the levels of the at least one or more selected PC-MACRO         markers in a control after the treatment, at the second time         point, or after administration of the compound, respectively;         and     -   e) identifying a fourth difference between the measured levels         of the at least one or more selected PC-NEUTRO markers in         steps c) and the levels of the at least one or more selected         PC-NEUTRO markers in a control after the treatment, at the         second time point, or after administration of the compound,         respectively;     -   f) identifying a difference between the first and second         differences; and     -   g) identifying a difference between the third and fourth         differences, wherein the differences identified in f) and g) are         indicative of the efficacy of the treatment for the prostate         cancer, or the progression or regression of the prostate cancer,         or whether the compound is capable of ameliorating or treating         the prostate cancer, respectively, in the subject.

In the fifth and sixth aspects, the selected PC-NEUTRO markers comprise one or more (e.g., two, three, four, five, six, seven, eight, nine, ten, or eleven) PC-NEUTRO Markers 1-11, e.g., EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, and PTMA and the selected PC-MACRO markers comprise one or more (e.g., two, three, four, or five) PC-MACRO Markers 1-4 and 105, i.e., P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1. In some embodiments, the selected markers are up-regulated (see Tables 2-5 for up-regulated markers) in prostate cancer patients. In some embodiments, the selected markers are down-regulated (see Tables 2-5 for down-regulated markers) in prostate cancer patients. In some embodiments, the selected markers comprise at least one marker (PC-MACRO or PC-NEUTRO marker) that is up-regulated and at least one marker (PC-MACRO or PC-NEUTRO marker) that is down-regulated. In some embodiments, the selected markers consist of EIF3S5, EEEF1A1, RPL23A, RPL14, RPL23A, RPL3, RPS28, PTMA, P2RY10, TNFAIP3, CXCR1, DNAJB1, and CHI3L1.

In some embodiments, two sub-populations of phagocytic cells are used in the methods of this invention, i.e., phagocytic cells that have a DNA content greater than 2n (the >2n phagocytic cells) and phagocytic cells that have a DNA content of 2n (the =2n phagocytic cells). In those embodiments, the levels of the selected markers in the >2n phagocytic cells are compared to the =2n phagocytic cells to identify one or more difference. The identified differences indicate whether the subject has prostate cancer, or has a risk of developing prostate cancer, or has a progressing or progressive prostate cancer.

In some embodiments, the levels of two, three, four, five, six, seven, eight, nine, ten, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, or more markers selected from Tables 2-5 are measured. In some embodiments, one or more marker selected from Tables 2 and 3 and one or more marker selected from Tables 4 and 5 are measured.

In various embodiments of the present invention, at least one or more of the selected markers (PC-MACRO markers or PC-NEUTRO markers) may be substituted with a biological marker different from any of the selected markers. In some embodiments, such biological markers may be known markers for prostate cancer. In some embodiments, such biological markers and the substituted selected markers may belong to the same signaling or biological pathway (e.g., a protein synthesis pathway, Th1 cytokine production pathway, transcription pathway, programmed cell death pathway), or may have similar biological function or activity (e.g., protein synthesis, Th1 cytokine production, nucleotide binding, protein binding, transcription, a receptor for purines coupled to G-proteins, inhibition of programmed cell death, neutrophil activation, an IL-8 receptor, an HSP70-interacting protein, stimulating ATPase activity), or may be regulated by a common protein, or may belong to the same protein complex (e.g., an HSP70 protein complex).

In various embodiments of the present invention, a population of the subject's macrophage cells is used as the selected phagocytic cells for measuring the levels of the selected markers (e.g., PC-MACRO markers) and a population of the subject's T-cells is used as the selected non-phagocytic cells for measuring the levels of the selected markers (e.g., PC-MACRO markers).

In various embodiments of the present invention, a population of the subject's neutrophil cells is used as the selected phagocytic cells for measuring the levels of the selected markers (e.g., PC-NEUTRO markers) and a population of the subject's T-cells is used as the selected non-phagocytic cells for measuring the levels of the selected markers (e.g., PC-NEUTRO markers).

The gene names/descriptions provided in Tables 2-5 are merely illustrative. The markers of this invention encompass all forms and variants of any specifically described markers, including, but not limited to, polymorphic or allelic variants, isoforms, mutants, derivatives, precursors including nucleic acids and pro-proteins, cleavage products, and structures comprised of any of the markers as constituent subunits of the fully assembled structure.

A “patient”, “subject”, or “individual” are used interchangeably and refer to either a human or a non-human animal. These terms include mammals, such as humans, primates, livestock animals (e.g., bovines, porcines), companion animals (e.g., canines, felines) and rodents (e.g., mice and rats).

As used herein, the terms “normal control”, “healthy control”, and “not-diseased cells” likewise mean a sample (e.g., cells, serum, tissue) taken from a source (e.g., subject, control subject, cell line) that does not have the condition or disease being assayed and therefore may be used to determine the baseline for the condition or disorder being measured. A control subject refers to any individual that has not been diagnosed as having the disease or condition being assayed. It is also understood that the control subject, normal control, and healthy control, include data obtained and used as a standard, i.e. it can be used over and over again for multiple different subjects. In other words, for example, when comparing a subject sample to a control sample, the data from the control sample could have been obtained in a different set of experiments, for example, it could be an average obtained from a number of healthy subjects and not actually obtained at the time the data for the subject was obtained.

The term “diagnosis” as used herein refers to methods by which the skilled artisan can estimate and/or determine whether or not a patient is suffering from a given disease or condition. In some embodiments, the term “diagnosis” also refers to staging (e.g., Stage I, II, III, or IV) of cancer. The skilled artisan often makes a diagnosis on the basis of one or more diagnostic indicators, e.g., a marker, the presence, absence, amount, or change in amount of which is indicative of the presence, severity, or absence of the condition.

The term “prognosis” as used herein refers to is used herein to refer to the likelihood of prostate cancer progression, including recurrence of prostate cancer.

The disclosure of the International Applications PCT/US11/44969, PCT/US11/45018, and PCT/US09/31395 and U.S. Provisional Applications 61/660,518 and 61/660,427 are incorporated herein by reference for all purposes.

Each embodiment described herein may be combined with any other embodiment described herein.

Methods using the prostate cancer markers described herein provide high specificity, sensitivity, and accuracy in detecting and diagnosing prostate cancer. The methods also eliminate the “inequality of baseline” that is known to occur among individuals due to intrinsic (e.g., age, gender, ethnic background, health status and the like) and temporal variations in marker expression. Additionally, by using a comparison of phagocytes and non-phagocytes from the same individual, the methods also allow detection, diagnosis, and treatment to be personalized to the individual. Accordingly, in some embodiments, the invention provides non-invasive assays for the early detection of prostate cancer, i.e., before the prostate cancer can be diagnosed by conventional diagnostic techniques, e.g., imaging techniques, and, therefore, provide a foundation for improved decision-making relative to the needs and strategies for intervention, prevention, and treatment of individuals with such disease or condition.

The methods described herein are supported by whole genome microarray data of total RNA samples isolated from macrophages and neutrophils and from non-phagocytic T cells. The samples were obtained from human subjects with and without prostate cancer. The data from these microarray experiments demonstrate that macrophage-T cell and neutrophil-T cell comparisons easily and accurately differentiate between prostate cancer patients and human subjects without prostate cancer.

The methods of this invention can be used together with any known diagnostic methods, such as physical inspection, visual inspection, biopsy, scanning, histology, radiology, imaging, ultrasound, use of a commercial kit, genetic testing, immunological testing, analysis of bodily fluids, or monitoring neural activity.

Phagocytic cells that can be used in the methods of this invention include all types of cells that are capable of ingesting various types of substances (e.g., apoptotic cells, infectious agents, dead cells, viable cells, cell-free DNAs, cell-free RNAs, cell-free proteins). In some embodiments, the phagocytic cells are neutrophils, macrophages, monocytes, dendritic cells, foam cells, mast cells, eosinophils, or keratinocytes. In some embodiments, the phagocytic cells can be a mixture of different types of phagocytic cells. In some embodiments, the phagocytic cells can be activated phagocytic cells, e.g., activated macrophages or neutrophils. In some embodiments, a phagocyte is a histiocyte, e.g., a Langerhans cell.

As used herein, “treating” prostate cancer refers to taking steps to obtain beneficial or desired results, including clinical results. Beneficial or desired clinical results include, but are not limited to, alleviation or amelioration of one or more symptoms associated with diseases or conditions.

As used herein, “administering” or “administration of” a compound or an agent to a subject can be carried out using one of a variety of methods known to those skilled in the art. For example, a compound or an agent can be administered, intravenously, arterially, intradermally, intramuscularly, intraperitonealy, intravenously, subcutaneously, ocularly, sublingually, orally (by ingestion), intranasally (by inhalation), intraspinally, intracerebrally, and transdermally (by absorbtion, e.g., through a skin duct). A compound or agent can also appropriately be introduced by rechargeable or biodegradable polymeric devices or other devices, e.g., patches and pumps, or formulations, which provide for the extended, slow, or controlled release of the compound or agent. Administering can also be performed, for example, once, a plurality of times, and/or over one or more extended periods. In some aspects, the administration includes both direct administration, including self-administration, and indirect administration, including the act of prescribing a drug. For example, as used herein, a physician who instructs a patient to self-administer a drug, or to have the drug administered by another and/or who provides a patient with a prescription for a drug is administering the drug to the patient. In some embodiments, a compound or an agent is administered orally, e.g., to a subject by ingestion, or intravenously, e.g., to a subject by injection. In some embodiments, the orally administered compound or agent is in an extended release or slow release formulation, or administered using a device for such slow or extended release.

In certain embodiments, markers used in the methods of invention are up-regulated or activated in phagocytes (e.g., macrophages or neutrophils) compared to non-phagocytes. In certain embodiments, markers used in the methods of invention are down-regulated or inhibited in phagocytes (e.g., macrophages or neutrophils) compared to non-phagocytes. As used herein, “up-regulation or up-regulated” can refer to an increase in expression levels (e.g., gene expression or protein expression), gene copy numbers, gene dosages, and other qualitative or quantitative detectable state of the markers. Similarly, “down-regulation or down-regulated” can refer to a decrease in expression levels, gene copy numbers, gene dosages, and other qualitative or quantitative detectable state of the markers. As used herein, “activation or activated” can refer to an active state of the marker, e.g., a phosphorylation state, a DNA methylation state, or a DNA acetylation state. Similarly, “inhibition or inhibited” can refer to a repressed state or an inactivated state of the marker, e.g., a de-phosphorylation state, a ubiquitination state, or a DNA de-methylation state.

In certain embodiments, methods of this invention also comprise at least one of the following steps before determination of various levels: i) lysing the phagocytic or non-phagocytic cells; and ii) extracting cellular contents from the lysed cells. Any known cell lysis and extraction methods can be used herein. In certain embodiments, at least one or more prostate cancer markers are present in the phagocytes. In certain embodiments, there is no marker present in the cellular contents of the non-phagocytic cells.

In certain embodiments, the phagocytic cells and/or non-phagocytic cells are isolated from a bodily fluid sample, tissues, or population of cells. Exemplary bodily fluid samples can be whole blood, urine, stool, saliva, lymph fluid, cerebrospinal fluid, synovial fluid, cystic fluid, ascites, pleural effusion, fluid obtained from a pregnant woman in the first trimester, fluid obtained from a pregnant woman in the second trimester, fluid obtained from a pregnant woman in the third trimester, maternal blood, amniotic fluid, chorionic villus sample, fluid from a preimplantation embryo, maternal urine, maternal saliva, placental sample, fetal blood, lavage and cervical vaginal fluid, interstitial fluid, buccal swab sample, sputum, bronchial lavage, Pap smear sample, or ocular fluid. In some embodiments, the phagocytic cells or non-phagocytic cells are isolated from white blood cells.

In the methods of this invention, cell separation/isolation/purification methods are used to isolate populations of cells from bodily fluid sample, cells, or tissues of a subject. A skilled worker can use any known cell separation/isolation/purification techniques to isolate phagocytic cells and non-phagocytic cells from a bodily fluid. Exemplary techniques include, but are not limited to, using antibodies, flow cytometry, fluorescence activated cell sorting, filtration, gradient-based centrifugation, elution, microfluidics, magnetic separation technique, fluorescent-magnetic separation technique, nanostructure, quantum dots, high throughput microscope-based platform, or a combination thereof.

In certain embodiments, the phagocytic cells and/or non-phagocytic cells are isolated by using a product secreted by the cells. In certain embodiments, the phagocytic cells and/or non-phagocytic cells are isolated by using a cell surface target (e.g., receptor protein) on the surface of the cells. In some embodiments, the cell surface target is a protein that has been engulfed by phagocytic cells. In some embodiments, the cell surface target is expressed by cells on their plasma membranes. In some embodiments, the cell surface target is an exogenous protein that is translocated on the plasma membranes, but not expressed by the cells (e.g., the phagocytic cells). In some embodiments, the cell surface target is a marker of prostate cancer.

In certain aspects of the methods described herein, analytes include nucleic acids, proteins, or any combinations thereof. In certain aspects of the methods described herein, markers include nucleic acids, proteins, or any combinations thereof. As used herein, the term “nucleic acid” is intended to include DNA molecules (e.g., cDNA or genomic DNA), RNA molecules (e.g., mRNA), DNA-RNA hybrids, and analogs of the DNA or RNA generated using nucleotide analogs. The nucleic acid molecule can be a nucleotide, oligonucleotide, double-stranded DNA, single-stranded DNA, multi-stranded DNA, complementary DNA, genomic DNA, non-coding DNA, messenger RNA (mRNAs), microRNA (miRNAs), small nucleolar RNA (snoRNAs), ribosomal RNA (rRNA), transfer RNA (tRNA), small interfering RNA (siRNA), heterogeneous nuclear RNAs (hnRNA), or small hairpin RNA (shRNA). In some embodiments, the nucleic acid is a transrenal nucleic acid. A transrenal nucleic acid is an extracellular nucleic acid that is excreted in the urine. See, e.g., U.S. Patent Publication No. 20100068711 and U.S. Patent Publication No. 20120021404.

As used herein, the term “amino acid” includes organic compounds containing both a basic amino group and an acidic carboxyl group. Included within this term are natural amino acids (e.g., L-amino acids), modified and unusual amino acids (e.g., D-amino acids and (3-amino acids), as well as amino acids which are known to occur biologically in free or combined form but usually do not occur in proteins. Natural protein occurring amino acids include alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine, serine, threonine, tyrosine, tryptophan, proline, and valine. Natural non-protein amino acids include arginosuccinic acid, citrulline, cysteine sulfuric acid, 3,4-dihydroxyphenylalanine, homocysteine, homoserine, ornithine, 3-monoiodotyrosine, 3,5-diiodotryosine, 3, 5, 5-triiodothyronine, and 3,3′,5,5′-tetraiodothyronine. Modified or unusual amino acids include D-amino acids, hydroxylysine, 4-hydroxyproline, N-Cbz-protected amino acids, 2,4-diaminobutyric acid, homoarginine, norleucine, N-methylaminobutyric acid, naphthylalanine, phenylglycine, α-phenylproline, tert-leucine, 4-aminocyclohexylalanine, N-methyl-norleucine, 3,4-dehydroproline, N,N-dimethylaminoglycine, N-methylaminoglycine, 4-aminopiperidine-4-carboxylic acid, 6-aminocaproic acid, trans-4-(aminomethyl)-cyclohexanecarboxylic acid, 2-, 3-, and 4-(aminomethyl)-benzoic acid, 1-aminocyclopentanecarboxylic acid, 1-aminocyclopropanecarboxylic acid, and 2-benzyl-5-aminopentanoic acid.

As used herein, the term “peptide” includes compounds that consist of two or more amino acids that are linked by means of a peptide bond. Peptides may have a molecular weight of less than 10,000 Daltons, less than 5,000 Daltons, or less than 2,500 Daltons. The term “peptide” also includes compounds containing both peptide and non-peptide components, such as pseudopeptide or peptidomimetic residues or other non-amino acid components. Such compounds containing both peptide and non-peptide components may also be referred to as a “peptide analog.”

As used herein, the term “protein” includes compounds that consist of amino acids arranged in a linear chain and joined together by peptide bonds between the carboxyl and amino groups of adjacent amino acid residues. Proteins used in methods of the invention include, but are not limited to, amino acids, peptides, antibodies, antibody fragments, cytokines, lipoproteins, or glycoproteins.

As used herein, the term “antibody” includes polyclonal antibodies, monoclonal antibodies (including full length antibodies which have an immunoglobulin Fc region), antibody compositions with polyepitopic specificity, multispecific antibodies (e.g., bispecific antibodies, diabodies, and single-chain molecules, and antibody fragments (e.g., Fab or F(ab′)₂, and Fv). For the structure and properties of the different classes of antibodies, see e.g., Basic and Clinical Immunology, 8th Edition, Daniel P. Sties, Abba I. Terr and Tristram G. Parsolw (eds), Appleton & Lange, Norwalk, Conn., 1994, page 71 and Chapter 6.

As used herein, the term “cytokine” refers to a secreted protein or active fragment or mutant thereof that modulates the activity of cells of the immune system. Examples of cytokines include, without limitation, interleukins, interferons, chemokines, tumor necrosis factors, colony-stimulating factors for immune cell precursors, and the like.

As used herein, the term “lipoprotein” includes negatively charged compositions that comprise a core of hydrophobic cholesteryl esters and triglyceride surrounded by a surface layer of amphipathic phospholipids with which free cholesterol and apolipoproteins are associated. Lipoproteins may be characterized by their density (e.g. very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL) and high density lipoprotein (HDL)), which is determined by their size, the relative amounts of lipid and protein. Lipoproteins may also be characterized by the presence or absence of particular modifications (e.g. oxidization, acetylation, or glycation).

As used herein, the term “glycoprotein” includes glycosides which have one or more oligo- or polysaccharides covalently attached to a peptide or protein. Exemplary glycoproteins can include, without limitation, immunoglobulins, members of the major histocompatibility complex, collagens, mucins, glycoprotein IIb/IIIa, glycoprotein-41 (gp41) and glycoprotein-120 (gp12), follicle-stimulating hormone, alpha-fetoprotein, erythropoietin, transferrins, alkaline phosphatase, and lectins.

In some embodiments of the invention, a sample may comprise one or more stabilizers for a cell or an analyte such as DNA, RNA, and/or protein. For example, a sample may comprise a DNA stabilizer, an RNA stabilizer, and/or a protein stabilizer. Stabilizers are well known in the art and include, for example, DNAse inhibitors, RNAse inhibitors, and protease inhibitors or equivalents thereof.

In some embodiments of the invention, levels of at least one or more prostate cancer markers are compared. This comparison can be quantitative or qualitative. Quantitative measurements can be taken using any of the assays described herein. For example, sequencing, direct sequencing, random shotgun sequencing, Sanger dideoxy termination sequencing, targeted sequencing, whole-genome sequencing, sequencing by hybridization, pyrosequencing, capillary electrophoresis, gel electrophoresis, duplex sequencing, cycle sequencing, single-base extension sequencing, solid-phase sequencing, high-throughput sequencing, massively parallel signature sequencing, emulsion PCR, co-amplification at lower denaturation temperature-PCR (COLD-PCR), sequencing by reversible dye terminator, paired-end sequencing, near-term sequencing, exonuclease sequencing, sequencing by ligation, short-read sequencing, single-molecule sequencing, sequencing-by-synthesis, real-time sequencing, reverse-terminator sequencing, nanopore sequencing, 454 sequencing, Solexa Genome Analyzer sequencing, SOLiD® sequencing, MS-PET sequencing, mass spectrometry, matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry, electrospray ionization (ESI) mass spectrometry, surface-enhanced laser deorption/ionization-time of flight (SELDI-TOF) mass spectrometry, quadrupole-time of flight (Q-TOF) mass spectrometry, atmospheric pressure photoionization mass spectrometry (APPI-MS), Fourier transform mass spectrometry (FTMS), matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance (MALDI-FT-ICR) mass spectrometry, secondary ion mass spectrometry (SIMS), polymerase chain reaction (PCR) analysis, quantitative PCR, real-time PCR, fluorescence assay, colorimetric assay, chemiluminescent assay, or a combination thereof.

Quantitative comparisons can include statistical analyses such as t-test, ANOVA, Krustal-Wallis, Wilcoxon, Mann-Whitney, and odds ratio. Quantitative differences can include differences in the levels of markers between levels or differences in the numbers of markers present between levels, and combinations thereof. Examples of levels of the markers can be, without limitation, gene expression levels, nucleic acid levels, and protein levels. Qualitative differences can include, but are not limited to, activation and inactivation, protein degradation, nucleic acid degradation, and covalent modifications.

In certain embodiments of the invention, the level is a nucleic acid level or a protein level, or a combination thereof. The level can be qualitatively or quantitatively determined.

A nucleic acid level can be, without limitation, a genotypic level, a single nucleotide polymorphism level, a gene mutation level, a gene copy number level, a DNA methylation level, a DNA acetylation level, a chromosome dosage level, a gene expression level, or a combination thereof.

The nucleic acid level can be determined by any methods known in the art to detect genotypes, single nucleotide polymorphisms, gene mutations, gene copy numbers, DNA methylation states, DNA acetylation states, chromosome dosages. Exemplary methods include, but are not limited to, polymerase chain reaction (PCR) analysis, sequencing analysis, electrophoretic analysis, restriction fragment length polymorphism (RFLP) analysis, Northern blot analysis, quantitative PCR, reverse-transcriptase-PCR analysis (RT-PCR), allele-specific oligonucleotide hybridization analysis, comparative genomic hybridization, heteroduplex mobility assay (HMA), single strand conformational polymorphism (SSCP), denaturing gradient gel electrophisis (DGGE), RNAase mismatch analysis, mass spectrometry, tandem mass spectrometry, matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry, electrospray ionization (ESI) mass spectrometry, surface-enhanced laser deorption/ionization-time of flight (SELDI-TOF) mass spectrometry, quadrupole-time of flight (Q-TOF) mass spectrometry, atmospheric pressure photoionization mass spectrometry (APPI-MS), Fourier transform mass spectrometry (FTMS), matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance (MALDI-FT-ICR) mass spectrometry, secondary ion mass spectrometry (SIMS), surface plasmon resonance, Southern blot analysis, in situ hybridization, fluorescence in situ hybridization (FISH), chromogenic in situ hybridization (CISH), immunohistochemistry (IHC), microarray, comparative genomic hybridization, karyotyping, multiplex ligation-dependent probe amplification (MLPA), Quantitative Multiplex PCR of Short Fluorescent Fragments (QMPSF), microscopy, methylation specific PCR (MSP) assay, HpaII tiny fragment Enrichment by Ligation-mediated PCR (HELP) assay, radioactive acetate labeling assays, colorimetric DNA acetylation assay, chromatin immunoprecipitation combined with microarray (ChIP-on-chip) assay, restriction landmark genomic scanning, Methylated DNA immunoprecipitation (MeDIP), molecular break light assay for DNA adenine methyltransferase activity, chromatographic separation, methylation-sensitive restriction enzyme analysis, bisulfite-driven conversion of non-methylated cytosine to uracil, co-amplification at lower denaturation temperature-PCR (COLD-PCR), multiplex PCR, methyl-binding PCR analysis, or a combination thereof.

As used herein, the term “sequencing” is used in a broad sense and refers to any technique known in the art that allows the order of at least some consecutive nucleotides in at least part of a nucleic acid to be identified, including without limitation at least part of an extension product or a vector insert. Exemplary sequencing techniques include targeted sequencing, single molecule real-time sequencing, whole transcriptome shotgun sequencing (“RNA-seq”), electron microscopy-based sequencing, transistor-mediated sequencing, direct sequencing, random shotgun sequencing, Sanger dideoxy termination sequencing, exon sequencing, whole-genome sequencing, sequencing by hybridization, pyrosequencing, capillary electrophoresis, gel electrophoresis, duplex sequencing, cycle sequencing, single-base extension sequencing, solid-phase sequencing, high-throughput sequencing, massively parallel signature sequencing, emulsion PCR, co-amplification at lower denaturation temperature-PCR (COLD-PCR), multiplex PCR, sequencing by reversible dye terminator, paired-end sequencing, near-term sequencing, exonuclease sequencing, sequencing by ligation, short-read sequencing, single-molecule sequencing, sequencing-by-synthesis, real-time sequencing, reverse-terminator sequencing, nanopore sequencing, 454 sequencing, Solexa Genome Analyzer sequencing, SOLiD® sequencing, MS-PET sequencing, mass spectrometry, and a combination thereof. In some embodiments, sequencing comprises an detecting the sequencing product using an instrument, for example but not limited to an ABI PRISM® 377 DNA Sequencer, an ABI PRISM® 310, 3100, 3100-Avant, 3730, or 373O×I Genetic Analyzer, an ABI PRISM® 3700 DNA Analyzer, or an Applied Biosystems SOLiD™ System (all from Applied Biosystems), a Genome Sequencer 20 System (Roche Applied Science), or a mass spectrometer. In certain embodiments, sequencing comprises emulsion PCR. In certain embodiments, sequencing comprises a high throughput sequencing technique, for example but not limited to, massively parallel signature sequencing (MPSS).

In further embodiments of the invention, a protein level can be a protein expression level, a protein activation level, or a combination thereof. In some embodiments, a protein activation level can comprise determining a phosphorylation state, an ubiquitination state, a myristoylation state, or a conformational state of the protein.

A protein level can be detected by any methods known in the art for detecting protein expression levels, protein phosphorylation state, protein ubiquitination state, protein myristoylation state, or protein conformational state. In some embodiments, a protein level can be determined by an immunohistochemistry assay, an enzyme-linked immunosorbent assay (ELISA), in situ hybridization, chromatography, liquid chromatography, size exclusion chromatography, high performance liquid chromatography (HPLC), gas chromatography, mass spectrometry, tandem mass spectrometry, matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry, electrospray ionization (ESI) mass spectrometry, surface-enhanced laser deorption/ionization-time of flight (SELDI-TOF) mass spectrometry, quadrupole-time of flight (Q-TOF) mass spectrometry, atmospheric pressure photoionization mass spectrometry (APPI-MS), Fourier transform mass spectrometry (FTMS), matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance (MALDI-FT-ICR) mass spectrometry, secondary ion mass spectrometry (SIMS), radioimmunoassays, microscopy, microfluidic chip-based assays, surface plasmon resonance, sequencing, Western blotting assay, or a combination thereof.

As used herein, the “difference” between different levels detected by the methods of this invention can refer to different gene copy numbers, different DNA, RNA, or protein expression levels, different DNA methylation states, different DNA acetylation states, and different protein modification states. The difference can be a difference greater than 1 fold. In some embodiments, the difference is a 1.05-fold, 1.1-fold, 1.2-fold, 1.3-fold, 1.4-fold, 1.5-fold, 2-fold, 2.5-fold, 3-fold, 4-fold, 5-fold, 6-fold, 7-fold, 8-fold, 9-fold, or 10-fold difference. In some embodiments, the difference is any fold difference between 1-10, 2-10, 5-10, 10-20, or 10-100 fold.

In some embodiments, the difference is differential gene expression (DGE), e.g. DGE of phagocytes vs. non-phagocytes. DGE can be measured as X=log₂(Y_(P))−log₂(Y_(NP)). The DGE may be any number, provided that it is significantly different between the phagocytes and the non-phagocytes. For example, a 2-fold increased in gene expression could be represented as X=log₂(Y_(P))−log₂(Y_(NP))=log₂(Y_(P)/Y_(NP))=log₂(2)=1, while a 2-fold decrease in gene expression could be represented as X=log₂(Y_(P))−log₂(Y_(NP))=log₂(Y_(P)/Y_(NP))=log₂(½)=−1. Down-regulated genes have X<0, while up-regulated genes have X>0. See, e.g., Efron, J Am Stat Assoc 104:1015-1028 (2009).

A general principle of assays to detect markers involves preparing a sample or reaction mixture that may contain the marker (e.g., one or more of DNA, RNA, or protein) and a probe under appropriate conditions and for a time sufficient to allow the marker and probe to interact and bind, thus forming a complex that can be removed and/or detected in the reaction mixture. These assays can be conducted in a variety of ways.

For example, one method to conduct such an assay would involve anchoring the marker or probe onto a solid phase support, also referred to as a substrate, and detecting target marker/probe complexes anchored on the solid phase at the end of the reaction. In one embodiment of such a method, a sample from a subject, which is to be assayed for presence and/or concentration of marker, can be anchored onto a carrier or solid phase support. In another embodiment, the reverse situation is possible, in which the probe can be anchored to a solid phase and a sample from a subject can be allowed to react as an unanchored component of the assay.

There are many established methods for anchoring assay components to a solid phase. These include, without limitation, marker or probe molecules which are immobilized through conjugation of biotin and streptavidin. Such biotinylated assay components can be prepared from biotin-NHS(N-hydroxy-succinimide) using techniques known in the art (e.g., biotinylation kit, Pierce Chemicals, Rockford, Ill.), and immobilized in the wells of streptavidin-coated 96 well plates (Pierce Chemical). In certain embodiments, the surfaces with immobilized assay components can be prepared in advance and stored.

Other suitable carriers or solid phase supports for such assays include any material capable of binding the class of molecule to which the marker or probe belongs. Well known supports or carriers include, but are not limited to, glass, polystyrene, nylon, polypropylene, nylon, polyethylene, dextran, amylases, natural and modified celluloses, polyacrylamides, gabbros, and magnetite.

In order to conduct assays with the above mentioned approaches, the non-immobilized component is added to the solid phase upon which the second component is anchored. After the reaction is complete, uncomplexed components may be removed (e.g., by washing) under conditions such that any complexes formed will remain immobilized upon the solid phase. The detection of marker/probe complexes anchored to the solid phase can be accomplished in a number of methods outlined herein.

In certain exemplary embodiments, the probe, when it is the unanchored assay component, can be labeled for the purpose of detection and readout of the assay, either directly or indirectly, with detectable labels discussed herein and which are well-known to one skilled in the art.

It is also possible to directly detect marker/probe complex formation without further manipulation or labeling of either component (marker or probe), for example by utilizing the technique of fluorescence energy transfer (see, for example, U.S. Pat. Nos. 5,631,169 and 4,868,103). A fluorophore label on the first, ‘donor’ molecule is selected such that, upon excitation with incident light of appropriate wavelength, its emitted fluorescent energy will be absorbed by a fluorescent label on a second ‘acceptor’ molecule, which in turn is able to fluoresce due to the absorbed energy. Alternately, the ‘donor’ protein molecule may simply utilize the natural fluorescent energy of tryptophan residues. Labels are chosen that emit different wavelengths of light, such that the ‘acceptor’ molecule label may be differentiated from that of the ‘donor’. Since the efficiency of energy transfer between the labels is related to the distance separating the molecules, spatial relationships between the molecules can be assessed. In a situation in which binding occurs between the molecules, the fluorescent emission of the ‘acceptor’ molecule label in the assay should be maximal. An FET binding event can be conveniently measured through standard fluorometric detection means well known in the art (e.g., using a fluorimeter).

In another embodiment, determination of the ability of a probe to recognize a marker can be accomplished without labeling either assay component (probe or marker) by utilizing a technology such as real-time Biomolecular Interaction Analysis (BIA) (see, e.g., Sjolander, S. and Urbaniczky, C, 1991, Anal. Chem. 63:2338 2345 and Szabo et al, 1995, Curr. Opin. Struct. Biol. 5:699 705). As used herein, “BIA” or “surface plasmon resonance” is a technology for studying biospecific interactions in real time, without labeling any of the interactants (e.g., BIAcore). Changes in the mass at the binding surface (indicative of a binding event) result in alterations of the refractive index of light near the surface (the optical phenomenon of surface plasmon resonance (SPR)), resulting in a detectable signal which can be used as an indication of real-time reactions between biological molecules.

Alternatively, in another embodiment, analogous diagnostic and prognostic assays can be conducted with marker and probe as solutes in a liquid phase. In such an assay, the complexed marker and probe are separated from uncomplexed components by any of a number of standard techniques, including but not limited to: differential centrifugation, chromatography, electrophoresis and immunoprecipitation. In differential centrifugation, marker/probe complexes may be separated from uncomplexed assay components through a series of centrifugal steps, due to the different sedimentation equilibria of complexes based on their different sizes and densities (see, for example, Rivas and Minton (1993) Trends Biochem. Sci. 18:284). Standard chromatographic techniques may also be utilized to separate complexed molecules from uncomplexed ones. For example, gel filtration chromatography separates molecules based on size, and through the utilization of an appropriate gel filtration resin in a column format, for example, the relatively larger complex may be separated from the relatively smaller uncomplexed components. Similarly, the relatively different charge properties of the marker/probe complex as compared to the uncomplexed components may be exploited to differentiate the complex from uncomplexed components, for example through the utilization of ion-exchange chromatography resins. Such resins and chromatographic techniques are well known to one skilled in the art (see, e.g., Heegaard (1998) J. MoI. Recognit. 11:141; Hage and Tweed (1997) J. Chromatogr. B. Biomed. Sci. Appl. 12:499). Gel electrophoresis may also be employed to separate complexed assay components from unbound components (see, e.g., Ausubel et al, ed., Current Protocols in Molecular Biology, John Wiley & Sons, New York, 1987 1999). In this technique, protein or nucleic acid complexes are separated based on size or charge, for example. In order to maintain the binding interaction during the electrophoretic process, non-denaturing gel matrix materials and conditions in the absence of reducing agent are typically preferred. Appropriate conditions to the particular assay and components thereof will be well known to one skilled in the art.

In certain exemplary embodiments, the level of mRNA corresponding to the marker can be determined either by in situ and/or by in vitro formats in a biological sample using methods known in the art. Many expression detection methods use isolated RNA. For in vitro methods, any RNA isolation technique that does not select against the isolation of mRNA can be utilized for the purification of RNA from blood cells (see, e.g., Ausubel et al, ed., Current Protocols in Molecular Biology, John Wiley & Sons, New York 1987 1999). Additionally, large numbers of cells and/or samples can readily be processed using techniques well known to those of skill in the art, such as, for example, the single-step RNA isolation process of Chomczynski (1989, U.S. Pat. No. 4,843,155).

Isolated mRNA can be used in hybridization or amplification assays that include, but are not limited to, Southern or Northern analyses, polymerase chain reaction analyses and probe arrays. In certain exemplary embodiments, a diagnostic method for the detection of mRNA levels involves contacting the isolated mRNA with a nucleic acid molecule (probe) that can hybridize to the mRNA encoded by the gene being detected. The nucleic acid probe can be, for example, a full-length cDNA, or a portion thereof, such as an oligonucleotide of at least 7, 15, 30, 50, 100, 250 or 500 nucleotides in length and sufficient to specifically hybridize under stringent conditions to an mRNA or genomic DNA encoding a marker of the present invention. Other suitable probes for use in the diagnostic assays of the invention are described herein. Hybridization of an mRNA with the probe indicates that the marker in question is being expressed.

In one format, the mRNA is immobilized on a solid surface and contacted with a probe, for example by running the isolated mRNA on an agarose gel and transferring the mRNA from the gel to a membrane, such as nitrocellulose. In an alternative format, the probe(s) are immobilized on a solid surface and the mRNA is contacted with the probe(s), for example, in a gene chip array. A skilled artisan can readily adapt known mRNA detection methods for use in detecting the level of mRNA encoded by the markers of the present invention.

An alternative method for determining the level of mRNA corresponding to a marker of the present invention in a sample involves the process of nucleic acid amplification, e.g., by RT-PCR (the experimental embodiment set forth in U.S. Pat. Nos. 4,683,195 and 4,683,202), COLD-PCR (Li et al. (2008) Nat. Med. 14:579), ligase chain reaction (Barmy, 1991, Proc. Natl. Acad. Sci. USA, 88:189), self sustained sequence replication (Guatelli et al., 1990, Proc. Natl. Acad. Sci. USA 87:1874), transcriptional amplification system (Kwoh et al. (1989) Proc. Natl. Acad. Sci. USA 86:1173), Q-Beta Replicase (Lizardi et al. (1988) Bio/Technology 6:1197), rolling circle replication (U.S. Pat. No. 5,854,033) or any other nucleic acid amplification method, followed by the detection of the amplified molecules using techniques well known to those of skill in the art. These detection schemes are especially useful for the detection of nucleic acid molecules if such molecules are present in very low numbers. As used herein, amplification primers are defined as being a pair of nucleic acid molecules that can anneal to 5′ or 3′ regions of a gene (plus and minus strands, respectively, or vice-versa) and contain a short region in between. In general, amplification primers are from about 10 to 30 nucleotides in length and flank a region from about 50 to 200 nucleotides in length. Under appropriate conditions and with appropriate reagents, such primers permit the amplification of a nucleic acid molecule comprising the nucleotide sequence flanked by the primers.

For in situ methods, mRNA does not need to be isolated from the sample (e.g., a bodily fluid (e.g., blood cells)) prior to detection. In such methods, a cell or tissue sample is prepared/processed using known histological methods. The sample is then immobilized on a support, typically a glass slide, and then contacted with a probe that can hybridize to mRNA that encodes the marker.

As an alternative to making determinations based on the absolute expression level of the marker, determinations may be based on the normalized expression level of the marker. Expression levels are normalized by correcting the absolute expression level of a marker by comparing its expression to the expression of a gene that is not a marker, e.g., a housekeeping gene that is constitutively expressed. Suitable genes for normalization include housekeeping genes such as the actin gene, or epithelial cell-specific genes. This normalization allows the comparison of the expression level in a patient sample from one source to a patient sample from another source, e.g., to compare a population of phagocytic from an individual to a population of non-phagocytic cells from the individual.

In one embodiment of this invention, a protein or polypeptide corresponding to a marker is detected. In certain embodiments, an agent for detecting a protein or polypeptide can be an antibody capable of binding to the polypeptide, such as an antibody with a detectable label. As used herein, the term “labeled,” with regard to a probe or antibody, is intended to encompass direct labeling of the probe or antibody by coupling (i.e., physically linking) a detectable substance to the probe or antibody, as well as indirect labeling of the probe or antibody by reactivity with another reagent that is directly labeled. Examples of indirect labeling include detection of a primary antibody using a fluorescently labeled secondary antibody and end-labeling of a DNA probe with biotin such that it can be detected with fluorescently labeled streptavidin. Antibodies can be polyclonal or monoclonal. An intact antibody, or a fragment thereof (e.g., Fab or F(ab′)2) can be used. In one format, antibodies, or antibody fragments, can be used in methods such as Western blots or immunofluorescence techniques to detect the expressed proteins. In such uses, it is generally preferable to immobilize either the antibody or proteins on a solid support. Suitable solid phase supports or carriers include any support capable of binding an antigen or an antibody. Well known supports or carriers include glass, polystyrene, polypropylene, polyethylene, dextran, nylon, amylases, natural and modified celluloses, polyacrylamides, gabbros, magnetite and the like.

A variety of formats can be employed to determine whether a sample contains a protein that binds to a given antibody. Examples of such formats include, but are not limited to, competitive and non-competitive immunoassay, enzyme immunoassay (EIA), radioimmunoassay (RIA), antigen capture assays, two-antibody sandwich assays, Western blot analysis, enzyme linked immunoabsorbant assay (ELISA), a planar array, a colorimetric assay, a chemiluminescent assay, a fluorescent assay, and the like Immunoassays, including radioimmmunoassays and enzyme-linked immunoassays, are useful in the methods of the present invention. A skilled artisan can readily adapt known protein/antibody detection methods for use in determining whether cells (e.g., bodily fluid cells such as blood cells) express a marker of the present invention.

One skilled in the art will know many other suitable carriers for binding antibody or antigen, and will be able to adapt such support for use with the present invention. For example, protein isolated from cells (e.g., bodily fluid cells such as blood cells) can be run on a polyacrylamide gel electrophoresis and immobilized onto a solid phase support such as nitrocellulose. The support can then be washed with suitable buffers followed by treatment with the detectably labeled antibody. The solid phase support can then be washed with the buffer a second time to remove unbound antibody. The amount of bound label on the solid support can then be detected by conventional means.

In certain exemplary embodiments, assays are provided for diagnosis, prognosis, assessing the risk of developing prostate cancer, assessing the efficacy of a treatment, monitoring the progression or regression of prostate cancer, and identifying a compound capable of ameliorating or treating prostate cancer. An exemplary method for these methods involves obtaining a bodily fluid sample from a test subject, isolating phagocytes and non-phagocytes, and contacting the phagocytes and non-phagocytes with a compound or an agent capable of detecting one or more of the markers of the disease or condition, e.g., marker nucleic acid (e.g., mRNA, genomic DNA), marker peptide (e.g., polypeptide or protein), marker lipid (e.g., cholesterol), or marker metabolite (e.g., creatinine) such that the presence of the marker is detected. In one embodiment, an agent for detecting marker mRNA or genomic DNA is a labeled nucleic acid probe capable of hybridizing to marker mRNA or genomic DNA. The nucleic acid probe can be, for example, a full-length marker nucleic acid or a portion thereof. Other suitable probes for use in the diagnostic assays of the invention are described herein.

As used herein, a compound capable of ameliorating or treating prostate cancer can include, without limitations, any substance that can improve symptoms or prognosis, prevent progression of the prostate cancer, promote regression of the prostate cancer, or eliminate the prostate cancer.

The methods of the invention can also be used to detect genetic alterations in a marker gene, thereby determining if a subject with the altered gene is at risk for developing prostate cancer characterized by misregulation in a marker protein activity or nucleic acid expression. In certain embodiments, the methods include detecting, in phagocytes, the presence or absence of a genetic alteration characterized by an alteration affecting the integrity of a gene encoding a marker peptide and/or a marker gene. For example, such genetic alterations can be detected by ascertaining the existence of at least one of: 1) a deletion of one or more nucleotides from one or more marker genes; 2) an addition of one or more nucleotides to one or more marker genes; 3) a substitution of one or more nucleotides of one or more marker genes, 4) a chromosomal rearrangement of one or more marker genes; 5) an alteration in the level of a messenger RNA transcript of one or more marker genes; 6) aberrant modification of one or more marker genes, such as of the methylation pattern of the genomic DNA; 7) the presence of a non-wild type splicing pattern of a messenger RNA transcript of one or more marker genes; 8) a non-wild type level of a one or more marker proteins; 9) allelic loss of one or more marker genes; and 10) inappropriate post-translational modification of one or more marker proteins. As described herein, there are a large number of assays known in the art which can be used for detecting alterations in one or more marker genes.

In certain embodiments, detection of the alteration involves the use of a probe/primer in a polymerase chain reaction (PCR) (see, e.g., U.S. Pat. Nos. 4,683,195, 4,683,202 and 5,854,033), such as real-time PCR, COLD-PCR (Li et al. (2008) Nat. Med. 14:579), anchor PCR, recursive PCR or RACE PCR, or, alternatively, in a ligation chain reaction (LCR) (see, e.g., Landegran et al. (1988) Science 241:1077; Prodromou and Pearl (1992) Protein Eng. 5:827; and Nakazawa et al. (1994) Proc. Natl. Acad. Sci. USA 91:360), the latter of which can be particularly useful for detecting point mutations in a marker gene (see Abravaya et al. (1995) Nucleic Acids Res. 23:675). This method can include the steps of collecting a sample of cell free bodily fluid from a subject, isolating nucleic acid (e.g., genomic, mRNA or both) from the sample, contacting the nucleic acid sample with one or more primers which specifically hybridize to a marker gene under conditions such that hybridization and amplification of the marker gene (if present) occurs, and detecting the presence or absence of an amplification product, or detecting the size of the amplification product and comparing the length to a control sample. It is anticipated that PCR and/or LCR may be desirable to use as a preliminary amplification step in conjunction with any of the techniques used for detecting mutations described herein.

Alternative amplification methods include: self sustained sequence replication (Guatelli et al., (1990) Proc. Natl. Acad. Sci. USA 87:1874), transcriptional amplification system (Kwoh et al., (1989) Proc. Natl. Acad. Sci. USA 86:1173), Q Beta Replicase (Lizardi et al. (1988) Bio-Technology 6:1197), or any other nucleic acid amplification method, followed by the detection of the amplified molecules using techniques well known to those of skill in the art. These detection schemes are especially useful for the detection of nucleic acid molecules if such molecules are present in very low numbers.

In an alternative embodiment, mutations in one or more marker genes from a sample can be identified by alterations in restriction enzyme cleavage patterns. For example, sample and control DNA is isolated, optionally amplified, digested with one or more restriction endonucleases, and fragment length sizes are determined by gel electrophoresis and compared. Differences in fragment length sizes between sample and control DNA indicates mutations in the sample DNA. Moreover, the use of sequence specific ribozymes (see, for example, U.S. Pat. No. 5,498,531) can be used to score for the presence of specific mutations by development or loss of a ribozyme cleavage site.

In other embodiments, genetic mutations in one or more of the markers described herein can be identified by hybridizing a sample and control nucleic acids, e.g., DNA or RNA, to high density arrays containing hundreds or thousands of oligonucleotides probes (Cronin et al. (1996) Human Mutation 7: 244; Kozal et al. (1996) Nature Medicine 2:753). For example, genetic mutations in a marker nucleic acid can be identified in two dimensional arrays containing light-generated DNA probes as described in Cronin, M. T. et al. supra. Briefly, a first hybridization array of probes can be used to scan through long stretches of DNA in a sample and control to identify base changes between the sequences by making linear arrays of sequential overlapping probes. This step allows the identification of point mutations. This step is followed by a second hybridization array that allows the characterization of specific mutations by using smaller, specialized probe arrays complementary to all variants or mutations detected. Each mutation array is composed of parallel probe sets, one complementary to the wild-type gene and the other complementary to the mutant gene.

In yet another embodiment, any of a variety of sequencing reactions known in the art can be used to directly sequence a marker gene and detect mutations by comparing the sequence of the sample marker gene with the corresponding wild-type (control) sequence. Examples of sequencing reactions include those based on techniques developed by Maxam and Gilbert ((1977) Proc. Natl. Acad. Sci. USA 74:560) or Sanger ((1977) Proc. Natl. Acad. Sci. USA 74:5463). It is also contemplated that any of a variety of automated sequencing procedures can be utilized when performing the diagnostic assays ((1995) Biotechniques 19:448), including sequencing by mass spectrometry (see, e.g., PCT International Publication No. WO 94/16101; Cohen et al. (1996) Adv. Chromatogr. 36:127-162; and Griffin et al. (1993) Appl. Biochem. Biotechnol. 38:147).

Other methods for detecting mutations in a marker gene include methods in which protection from cleavage agents is used to detect mismatched bases in RNA/RNA or RNA/DNA heteroduplexes (Myers et al. (1985) Science 230:1242). In general, the art technique of “mismatch cleavage” starts by providing heteroduplexes formed by hybridizing (labeled) RNA or DNA containing the wild-type marker sequence with potentially mutant RNA or DNA obtained from a tissue sample. The double-stranded duplexes are treated with an agent which cleaves single-stranded regions of the duplex such as which will exist due to base pair mismatches between the control and sample strands. For instance, RNA/DNA duplexes can be treated with RNase and DNA/DNA hybrids treated with 51 nuclease to enzymatically digesting the mismatched regions. In other embodiments, either DNA/DNA or RNA/DNA duplexes can be treated with hydroxylamine or osmium tetroxide and with piperidine in order to digest mismatched regions. After digestion of the mismatched regions, the resulting material is then separated by size on denaturing polyacrylamide gels to determine the site of mutation. See, for example, Cotton et al. (1988) Proc. Natl. Acad. Sci. USA 85:4397; Saleeba et al. (1992) Methods Enzymol. 217:286. In one embodiment, the control DNA or RNA can be labeled for detection.

In still another embodiment, the mismatch cleavage reaction employs one or more proteins that recognize mismatched base pairs in double-stranded DNA (so called “DNA mismatch repair” enzymes) in defined systems for detecting and mapping point mutations in marker cDNAs obtained from samples of cells. For example, the mutY enzyme of E. coli cleaves A at G/A mismatches and the thymidine DNA glycosylase from HeLa cells cleaves T at G/T mismatches (Hsu et al. (1994) Carcinogenesis 15:1657). According to an exemplary embodiment, a probe based on a marker sequence, e.g., a wild-type marker sequence, is hybridized to a cDNA or other DNA product from a test cell(s). The duplex is treated with a DNA mismatch repair enzyme, and the cleavage products, if any, can be detected from electrophoresis protocols or the like. See, for example, U.S. Pat. No. 5,459,039.

In other embodiments, alterations in electrophoretic mobility will be used to identify mutations in marker genes. For example, single strand conformation polymorphism (SSCP) may be used to detect differences in electrophoretic mobility between mutant and wild type nucleic acids (Orita et al. (1989) Proc. Natl. Acad. Sci. USA 86:2766, see also Cotton (1993) Mutat. Res. 285:125; and Hayashi (1992) Genet. Anal. Tech. Appl. 9:73). Single-stranded DNA fragments of sample and control marker nucleic acids will be denatured and allowed to renature. The secondary structure of single-stranded nucleic acids varies according to sequence, the resulting alteration in electrophoretic mobility enables the detection of even a single base change. The DNA fragments may be labeled or detected with labeled probes. The sensitivity of the assay may be enhanced by using RNA (rather than DNA), in which the secondary structure is more sensitive to a change in sequence. In one embodiment, the subject method utilizes heteroduplex analysis to separate double stranded heteroduplex molecules on the basis of changes in electrophoretic mobility (Keen et al. (1991) Trends Genet. 7:5).

In yet another embodiment the movement of mutant or wild-type fragments in polyacrylamide gels containing a gradient of denaturant is assayed using denaturing gradient gel electrophoresis (DGGE) (Myers et al. (1985) Nature 313:495). When DGGE is used as the method of analysis, DNA will be modified to insure that it does not completely denature, for example by adding a GC clamp of approximately 40 bp of high-melting GC-rich DNA by PCR. In a further embodiment, a temperature gradient is used in place of a denaturing gradient to identify differences in the mobility of control and sample DNA (Rosenbaum and Reissner (1987) Biophys. Chem. 265:12753).

Examples of other techniques for detecting point mutations include, but are not limited to, selective oligonucleotide hybridization, selective amplification or selective primer extension. For example, oligonucleotide primers may be prepared in which the known mutation is placed centrally and then hybridized to target DNA under conditions which permit hybridization only if a perfect match is found (Saiki et al. (1986) Nature 324:163; Saiki et al. (1989) Proc. Natl. Acad. Sci. USA 86:6230). Such allele specific oligonucleotides are hybridized to PCR amplified target DNA or a number of different mutations when the oligonucleotides are attached to the hybridizing membrane and hybridized with labeled target DNA.

Alternatively, allele specific amplification technology which depends on selective PCR amplification may be used in conjunction with the instant invention. Oligonucleotides used as primers for specific amplification may carry the mutation of interest in the center of the molecule (so that amplification depends on differential hybridization) (Gibbs et al. (1989) Nucl. Acids Res. 17:2437) or at the extreme 3′ end of one primer where, under appropriate conditions, mismatch can prevent, or reduce polymerase extension (Prossner (1993) Tibtech 11:238). In addition it may be desirable to introduce a novel restriction site in the region of the mutation to create cleavage-based detection (Gasparini et al. (1992) Mol. Cell Probes 6:1). It is anticipated that in certain embodiments amplification may also be performed using Taq ligase for amplification (Barany (1991) Proc. Natl. Acad. Sci. USA 88:189). In such cases, ligation will occur only if there is a perfect match at the 3′ end of the 5′ sequence making it possible to detect the presence of a known mutation at a specific site by looking for the presence or absence of amplification.

An exemplary method for detecting the presence or absence of an analyte (e.g., DNA, RNA, protein, polypeptide, or the like) corresponding to a marker of the invention in a biological sample involves obtaining a bodily fluid sample (e.g., blood) from a test subject and contacting the bodily fluid sample with a compound or an agent capable of detecting one or more markers. Detection methods described herein can be used to detect one or more markers in a biological sample in vitro as well as in vivo. For example, in vitro techniques for detection of mRNA include Northern hybridizations and in situ hybridizations. In vitro techniques for detection of a polypeptide corresponding to a marker of the invention include enzyme linked immunosorbent assays (ELISAs), Western blots, immunoprecipitations and immunofluorescence. In vitro techniques for detection of genomic DNA include Southern hybridizations. Furthermore, in vivo techniques for detection of a polypeptide corresponding to a marker of the invention include introducing into a subject a labeled antibody directed against the polypeptide. For example, the antibody can be labeled with a radioactive marker whose presence and location in a subject can be detected by standard imaging techniques. Because each marker is also an analyte, any method described herein to detect the presence or absence of a marker can also be used to detect the presence or absence of an analyte.

The markers useful in the methods of the invention can include any mutation in any one of the markers. Mutation sites and sequences can be identified, for example, by databases or repositories of such information, e.g., The Human Gene Mutation Database (www.hgmd.cf.ac.uk), the Single Nucleotide Polymorphism Database (dbSNP, www.ncbi.nlm.nih.gov/projects/SNP), and the Online Mendelian Inheritance in Man (OMIM) website (www.ncbi.nlm.nih.gov/omim).

The present invention also provides kits that comprise marker detection agents that detect at least one or more of the prostate cancer markers described herein.

The present invention also provides methods of treating or preventing prostate cancer in a subject comprising administering to said subject an agent that modulates the activity or expression or disrupts the function of at least one or more of the markers of this invention.

The one or more markers identified by this invention (e.g., markers in Tables 2-5) may be used in the treatment of prostate cancer. For example, a marker (e.g., a protein or gene) identified by the present invention may be used as a molecular target for a therapeutic agent. A marker identified by the invention also may be used in any of the other methods of the invention, e.g., for monitoring the progression or regression of a disease or condition. In certain embodiments, the one or more markers identified by the methods of this invention may have therapeutic potential. For example, if a marker is identified as being up-regulated (or down-regulated), see, for example, the up-regulated (or down-regulated) markers in Tables 2-5, or activated (or inhibited) in phagocytic cells from a subject having prostate cancer, a compound or an agent that is capable of down-regulating (or up-regulating) or inhibiting (or activating) said marker may be useful in treating prostate cancer. Similarly, a gene protein expression level, a protein expression level, or a combination thereof may be useful in this aspect of the invention.

Unless otherwise defined herein, scientific and technical terms used in this application shall have the meanings that are commonly understood by those of ordinary skill in the art. Generally, nomenclature used in connection with, and techniques of, cell and tissue culture, molecular biology, cell and cancer biology, neurobiology, neurochemistry, virology, immunology, microbiology, pharmacology, genetics and protein and nucleic acid chemistry, described herein, are those well known and commonly used in the art.

All of the above, and any other publications, patents and published patent applications referred to in this application are specifically incorporated by reference herein. In case of conflict, the present specification, including its specific definitions, will control.

Throughout this specification, the word “comprise” or variations such as “comprises” or “comprising” will be understood to imply the inclusion of a stated integer (or components) or group of integers (or components), but not the exclusion of any other integer (or components) or group of integers (or components).

The singular forms “a,” “an,” and “the” include the plurals unless the context clearly dictates otherwise.

The term “including” is used to mean “including but not limited to.” “Including” and “including but not limited to” are used interchangeably.

It is to be understood that the embodiments of the present invention which have been described are merely illustrative of some of the applications of the principles of the present invention. Numerous modifications may be made by those skilled in the art based upon the teachings presented herein without departing from the true spirit and scope of the invention.

The following examples are set forth as being representative of the present invention. These examples are not to be construed as limiting the scope of the invention as these and other equivalent embodiments will be apparent in view of the present disclosure and accompanying claims.

EXAMPLES Example 1: Microarray Analysis of Prostate Cancer Patients Study Population

Blood samples were collected from 62 prostate cancer patients. To meet 25 the criteria of obtaining blood only from naïve patients who had not undergone any treatment prior to blood draw, four patients who had received either chemo and/or radiation therapy prior to blood draw were excluded. Embedded tumor and adjacent “normal prostate” tissues were available from 42 of the 58 patients. Gleason scores, staging information, and serum PSA levels (determined prior to surgery) were available from all (Table 1). Approximately 10 ml of blood was collected from each patient into purple top blood collection EDTA tubes (BD Biosciences, CA) one to two weeks before radical prostatectomy. Within 3 hours, macrophages, neutrophils and T cells were isolated from each blood sample and total RNA was extracted and purified on the same day. Healthy control blood samples were obtained from apheresis collars of anonymous platelet donors. Gender determination of the blood donors was performed by PCR using two sets of 5 primers, SRY primers (Forward: 5′-CAG TGT GAA ACG GGA GAA AAC AG-3′ (SEQ ID NO:1); Reverse: 5′-ACT TCG CTG CAG AGT ACC GAA G-3′ (SEQ ID NO:2)) amplifying a 336 bp fragment on Y chromosome and AR6 primers (Forward: 5′-CAA TCA GAG ACA TTC CCT CTG G-3′ (SEQ ID NO:3); Reverse: 5′-AGT GGT CCT CTC TGAATC TC-3′ (SEQ ID NO:4)) amplifying a 267 bp fragment on X chromosome (males have both fragments amplified; females have only one). The PCR (36 cycles) was done under the conditions of 95° C. for 45 seconds, 56° C. for 45 seconds, and 72° C. for 45 seconds.

TABLE 1 Characteristics of 58 prostate cancer patients Parameter No. of patients % of total Median (range) Age (yrs) 60 (48-73) <50  1 1.7 50-60 31 53.5 >60  26 44.8 Race N/A White 51 87.9 Non-white 3 5.2 Unknown 4 6.9 PSA (ng/ml) 4.77 (0.05-23.80) ≤4  14 24.1 >4  44 75.9 Biopsy Gleason Score 7 (6-9) 6 19 32.8 7 34 58.6 8 4 6.9 9 1 1.7 Pathologic staging N/A pT1c 2 3.4 pT2a 5 8.6 pT2b 40 69.0 pT3a 8 13.8 pT3b 3 5.2 Isolation of Macrophages (M), Neutrophils (N), and T Cells (TC) from Whole Blood

7 mL of 1×PBS containing 2% FBS and 2 mM EDTA were added to approximately 5 mL of whole blood, the sample centrifuged (2,000 RPM, 10 minutes at 20° C.). The buffy coat was removed and centrifuged (2,000 RPM, 10 minutes at 20° C.). The cell pellet was then suspended in −1 mL of PBS and transferred to a 1.5 mL microfuge tube. Next, macrophages, neutrophils, and T cells were isolated using magnetic beads coated with antibodies specific to each of the three cell types (positive cell depletion). Cells were separated from the buffy coat always in the following sequence: 1) macrophages; 2) neutrophils; and 3) T cells (changing the order did not alter the RNA yield and quality). The freshly isolated white blood cell samples (in −1 mL PBS) were incubated (25 min, 4° C., constant shaking) first with anti-monocyte coated Dynabeads® (CD14—Cat. No. 11149D, Life Technologies), then with anti-neutrophil coated Dynabeads® (CD15—Cat. No. 11137D, Life Technologies), and finally with anti-T cell coated Dynabeads® (CD2 Pan T—Cat. No. 11159D, Life Technologies). Following each incubation, the bead-bound cells were separated using a magnet. The purity of these white blood cell subpopulations, which per manufacturer's specifications (Life Technologies) is >95%, was evident from the unique gene expression pattern obtained (cluster analysis). As soon as each white blood cell subpopulation was isolated, the magnetic bead bound cells were washed with 1×PBS and lysed in Trizol®. The fractionation and subsequent lysis of all the three types of cells were completed in less than 2 hours after the isolation of the buffy coat.

Total RNA Isolation

Total RNA was extracted from cells and tissues with Trizol® and the Pure-Link RNA isolation kit (Cat. #12183018A, Life Technologies). The quantity and purity of the RNA samples were determined on a Bioanalyzer 2100 (Agilent Technologies) and the Degradometer software (version 1.41). In general, the RIN and 28s/18s ratios were always found to be in the satisfactory range, ≥9 and ≥1.9, respectively.

Whole Genome Microarray Data Analysis

Total RNA from macrophages, neutrophils, T cells, tumor tissue (TT), and “normal” prostate tissue (NT) of prostate cancer patients, and from macrophages, neutrophils, and T cells extracted from healthy male blood donors were used in gene expression profiling. Biotinylated cDNA probes were prepared from 100 ng of each RNA sample, fragmented, and hybridized with Human Gene 1.0 ST chip (Affymetrix). Array signals of fluorescence were scanned, captured and recorded as CEL files. All the processing and analysis of the data were done using R 49 and Bioconductor software packages. To obtain the log 2 transformed expression levels, the raw data files obtained in CEL file format were pre-processed using the oligo package and the RMA (robust multichip average algorithm) routine to background correct, quantile normalize and summarize at the core level.

Example 2: Statistical Analysis of Microarray Data

Working with microarray data can be challenging because large numbers of genes can increase the likelihood of false positives, while a small number of samples can lead to overfitting. These issues can be overcome by using statistical methods to reduce the false rate of positives and using independent training and test data sets (e.g., cross-validation) to avoid overfitting. In particular, instead of using a “typical” 5% significance level, the false discovery rate (FDR) can be controlled to ensure that only 5% of the genes that are discovered are false positives, and Empirical Bayesian estimates can be used to improve test statistics.

Because an overfit model will perform poorly on an independent test set, a good test of the fit of a model is how well is performs on an independent test set. For small sample sizes, splitting data into test and training sets may leave too small of a data set for good training. This issue can be solved by using cross-validation, which splits the data into K-folds, trains the method on K−1 of the folds, and tests the method on the last fold. FIG. 1 depicts a diagram of a three-fold cross validation, wherein the diagnostic accuracy is averaged from the three splits. The ideal split for cross-validation is 10-fold for accurate and precise estimates of diagnostic accuracy. In a 10-fold cross validation, however, there are more than 10 splits because there are many choices for which data points go into the folds. For example, with the microarray data collected as described above, there are 50,979,600 ways to form 90% training/10% testing data sets.

The Empirical Bayesian method was used as follows:

-   -   1. The differential gene expression (DE) of phagocytes         (macrophages or neutrophils) vs. T cells was calculated for each         gene. DE is expressed as the log of the ratio of phagocyte to T         cell expression: DE=log(GE_(P)/GE_(TC)), where GE_(P) is         phagocyte gene expression and GE_(TC) is T cell gene expression.     -   2. The mean DE was compared in cancer and control patients with         a two-sample t-test. Empirical Bayes estimates of the test         statistics “shrink” these toward zero. An ordered list of these         test statistics was created, as shown by the exemplary prostate         cancer macrophage genes in FIG. 2 .     -   3. Calculate a diagnostic signature with K genes:

$S = {\sum\limits_{i = 1}^{K}{w_{i}\left( {{DE}_{i} - \mu_{i}} \right)}}$

-   -   If S>0, then the patient was diagnosed with cancer.     -   4. The number of genes K to include in the signature was         determined by comparing misclassification rates in independent         test sets with cross-validation.         Errors were calculated using an average of 1-sensitivity and         1-specificity, and the cross-validated error was used to select         markers (FIG. 3 ).

Using the above methods, the markers associated with prostate cancer in macrophages vs. T cells (Tables 2 and 3) and the markers associated with prostate cancer in neutrophils vs. T cells (Tables 4 and 5) were identified. Of these, specific signatures of four markers (for macrophages) and 11 markers (for neutrophils) also were identified that give especially high sensitivity and specificity. For example, a four-marker signature (PC-MACRO 1-4) from macrophages has a sensitivity of 100% and a specificity of 99.4%. The four genes identified were:

-   -   1. P2RY10: purinergic receptor P2Y (associated with leukemia,         lymphoma, pancreatic and soft tissue/muscle tissue tumors);     -   2. TNFAIP3: tumor necrosis factor, alpha-induced protein 3         (associated with adrenal, breast, cervical, colorectal,         gastrointestinal, germ cell, prostate, kidney, liver, lung,         ovarian, pancreatic, primitive neuroectodermal, skin, soft         tissue/muscle, uterine tumors, leukemia, chondrosarcoma,         lymphoma, glioma, non-neoplasia) inhibitor of programmed cell         death;     -   3. CSCR1: chemokine (C—X—C motif) receptor 1 (associated with         leukemia) interleukin-8 receptor (inflammatory response); and     -   4. DNAJB1: DnaJ homolog, subfamily B, member 1 (associated with         breast, cervical, colorectal, esophageal, gastrointestinal, germ         cell, prostate, kidney, liver, lung, ovarian, pancreatic,         primitive neuroectodermal, skin, soft tissue/muscle, and uterine         tumors, leukemia, prostate cancer, chondrosarcoma, lymphoma,         glioma, non-neoplasia, bladder carcinoma, retinoblastoma) heat         shock protein binding, chaperone mediated protein folding         requiring cofactor.

FIG. 5 shows a summary of the prostate cancer markers identified from macrophages and from neutrophils, as compared to T cells from the same individuals, for the PC-MACRO 1-100, PC-MACRO 101-200, PC-NEUTRO 1-100, and PC-NEUTRO 101-200 markers. Specifically, average error, sensitivity, and specificity values are given for a four marker panel from PC-MACRO 1-100 (PC-MACRO 1-4), a five marker panel from PC-MACRO 101-200 (PC-MACRO 101-105), an 11 marker panel from PC-NEUTRO 1-100 (PC-NEUTRO 1-11), and a five marker panel from PC-NEUTRO 101-200 (PC-NEUTRO 101-105). FIG. 7 demonstrates the power of a paired within-subject (phagocyte to non-phagocyte) comparison to detect prostate cancer as compared to phagocytes not paired with T cell data for comparison. The paired approach (comparing macrophage or neutrophils to T cell expression) is better than the phagocyte gene expression alone.

TABLE 2 Macrophage prostate cancer markers (PC-MACRO) 1-100 PC- Transcript Control Cancer MACRO Cluster ID mean mean Pattern 1 8168524 0.02960015 0.17371456 cancer upregulated 2 8122265 0.2072961 0.64660566 cancer upregulated 3 8058905 0.79419747 9.01125215 cancer upregulated 4 8034837 0.30827525 0.59910162 cancer upregulated 5 7961371 0.15160079 0.35670899 cancer upregulated 6 7903592 0.13849989 1.06724942 cancer upregulated 7 7962516 0.0203181 0.04210984 cancer upregulated 8 7930413 0.55491407 1.29068269 cancer upregulated 9 7952036 0.55537645 1.25160155 cancer upregulated 10 8174361 0.61722782 0.99292328 cancer upregulated 11 8037205 0.58997357 2.11572726 cancer upregulated 12 7920575 0.39329959 0.62620162 cancer upregulated 13 8119016 0.36673125 0.69477584 cancer upregulated 14 8052654 2.17872272 5.21317113 cancer upregulated 15 7923547 1.25355687 8.47033089 cancer upregulated 16 8083569 0.47715218 1.04210643 cancer upregulated 17 7923917 0.02901112 0.0622508 cancer upregulated 18 8072328 0.40442136 0.82657902 cancer upregulated 19 8003601 0.77897628 1.16646463 cancer upregulated 20 8000702 0.77897628 1.16646463 cancer upregulated 21 8146550 2.75450762 4.74699662 cancer upregulated 22 8001317 0.80092363 1.41111983 cancer upregulated 23 7926916 0.11459634 0.31950013 cancer upregulated 24 8097461 3.60707506 1.37545092 cancer downregulated 25 8095728 10.5690588 1.61196238 cancer downregulated 26 8070720 3.2097594 1.47073612 cancer downregulated 27 8063382 2.40434209 1.17896762 cancer downregulated 28 7972805 5.28713747 2.35650501 cancer downregulated 29 7955589 6.54462725 2.28292516 cancer downregulated 30 7900426 1.28882569 1.93805477 cancer upregulated 31 7922474 0.76633493 1.34565158 cancer upregulated 32 7899253 0.69522433 1.75493876 cancer upregulated 33 8048227 1.44379397 9.95849988 cancer upregulated 34 7929032 0.58060723 1.01380895 cancer upregulated 35 7904361 0.08449196 0.31032318 cancer upregulated 36 8179263 0.87218945 2.232133 cancer upregulated 37 8177983 0.87218945 2.232133 cancer upregulated 38 8118142 0.87218945 2.232133 cancer upregulated 39 7961142 4.74853476 1.1168988 cancer downregulated 40 7958262 0.79461476 1.39716641 cancer upregulated 41 7898693 1.15920613 6.21826436 cancer upregulated 42 8130768 1.37675482 2.14622801 cancer upregulated 43 8036710 1.01224589 1.46693108 cancer upregulated 44 8116983 4.10900898 1.91359618 cancer downregulated 45 8000482 0.72945776 1.3563131 cancer upregulated 46 7978595 1.08988349 1.72579173 cancer upregulated 47 8078014 2.64661452 4.48150446 cancer upregulated 48 7998931 0.75839436 1.1521868 cancer upregulated 49 7987192 1.41678085 2.19019682 cancer upregulated 50 8103226 3.21824227 5.86388463 cancer upregulated 51 8114010 0.99048925 1.76524384 cancer upregulated 52 8025672 0.55755809 1.01345746 cancer upregulated 53 8016540 1.18977345 4.2507857 cancer upregulated 54 7945169 0.32493882 0.99411563 cancer upregulated 55 7999642 0.84943451 1.19058275 cancer upregulated 56 8075316 3.9521795 1.67634544 cancer downregulated 57 8114572 12.8027337 3.97022993 cancer downregulated 58 8019885 0.69601899 1.27835261 cancer upregulated 59 8019877 0.64706614 1.14703044 cancer upregulated 60 7974920 0.03658486 0.10583053 cancer upregulated 61 8092691 4.31398434 8.88039871 cancer upregulated 62 8124280 0.56453876 0.85399528 cancer upregulated 63 8062927 1.10649927 5.23596961 cancer upregulated 64 7958600 1.17446597 1.72020153 cancer upregulated 65 7974870 1.83021593 1.13565448 cancer downregulated 66 7929616 1.46879694 2.74881528 cancer upregulated 67 8119898 7.26271784 3.23095057 cancer downregulated 68 7945944 1.63739015 2.27047063 cancer upregulated 69 8024582 0.43651409 0.69802531 cancer upregulated 70 7940287 0.29903959 0.81965175 cancer upregulated 71 7946559 2.03180864 3.35098913 cancer upregulated 72 7924603 1.01883127 1.48695002 cancer upregulated 73 8066905 0.89267917 1.25423704 cancer upregulated 74 7923233 0.31387565 0.49612974 cancer upregulated 75 8072346 0.60513857 0.85285694 cancer upregulated 76 8127145 1.30383618 0.89535391 cancer upregulated 77 8026564 0.82494247 0.53502655 cancer upregulated 78 7922846 2.02777211 0.8219638 cancer upregulated 79 7956819 2.14980211 1.22057225 cancer upregulated 80 8105778 0.42568173 0.2740702 cancer upregulated 81 8104492 2.19340942 0.74828404 cancer upregulated 82 8072744 8.62872444 4.38539283 cancer upregulated 83 7973352 1.62434306 0.87111779 cancer upregulated 84 8064438 2.1394305 1.41278384 cancer upregulated 85 8094743 0.06926233 0.03501436 cancer upregulated 86 8093993 1.09580389 0.80768602 cancer upregulated 87 8177951 1.30231682 0.78155345 cancer upregulated 88 8061373 1.41841367 2.41679805 cancer downregulated 89 8086125 0.71037012 0.39842202 cancer upregulated 90 8026047 3.06943153 1.50812928 cancer upregulated 91 8090577 1.44383677 1.04964813 cancer upregulated 92 8117330 0.80516115 0.38633404 cancer upregulated 93 7954711 0.85606841 0.49112958 cancer upregulated 94 7909610 1.25347387 2.22353869 cancer downregulated 95 7897482 1.20067741 0.87744585 cancer upregulated 96 8156848 1.04872188 2.61444722 cancer downregulated 97 8099797 2.18785448 1.41539173 cancer upregulated 98 8078214 1.4099199 1.09850026 cancer upregulated 99 7901054 2.07831718 1.0928931 cancer upregulated 100 8008870 3.86152022 2.72090652 cancer upregulated

TABLE 3 Macrophage prostate cancer markers (PC-MACRO) 101-200 Transcript PC- Cluster Control Cancer MACRO ID Gene Name mean mean Pattern 101 8168524 P2RY10 0.152005 0.029718 cancer upregulated 102 8122265 TNFAIP3 0.611381 0.207375 cancer upregulated 103 8058905 CXCR1 9.262282 0.792206 cancer upregulated 104 8034837 DNAJB1 0.577777 0.306905 cancer upregulated 105 7923547 CHI3L1 9.146662 1.258933 cancer upregulated 106 7903592 KIAA1324 1.149342 0.13814 cancer upregulated 107 8037205 CEACAM1 2.222375 0.575345 cancer upregulated 108 8083569 TIPARP 1.072432 0.472752 cancer upregulated 109 7898693 ALPL 6.626161 1.146884 cancer upregulated 110 7962516 SLC38A1 0.04104 0.020194 cancer upregulated 111 7920575 PBXIP1 0.617361 0.3943 cancer upregulated 112 7961371 DUSP16 0.330336 0.152073 cancer upregulated 113 8179263 TNF 2.369374 0.866687 cancer upregulated 114 8177983 TNF 2.369374 0.866687 cancer upregulated 115 8118142 TNF 2.369374 0.866687 cancer upregulated 116 7899253 ZDHHC18 1.744595 0.688354 cancer upregulated 117 7930413 DUSP5 1.274755 0.55359 cancer upregulated 118 8062927 PI3 5.154207 1.0788 cancer upregulated 119 8016540 PHOSPHO1 4.471143 1.194592 cancer upregulated 120 7952036 MPZL3 1.249639 0.548515 cancer upregulated 121 8048227 CXCR2 10.73569 1.46568 cancer upregulated 122 7923917 FAIM3 0.057531 0.029321 cancer upregulated 123 8119016 MAPK13 0.664511 0.35986 cancer upregulated 124 8104492 ROPN1L 2.327292 0.73435 cancer upregulated 125 8174361 TSC22D3 0.981877 0.622134 cancer upregulated 126 7996100 GPR97 4.78039 1.14386 cancer upregulated 127 7904361 FAM46C 0.294853 0.081631 cancer upregulated 128 8114572 HBEGF 3.818586 13.18658 cancer downregulated 129 8095728 EREG 1.674886 11.07804 cancer downregulated 130 7974870 SNAP 1.085902 1.836496 cancer downregulated 131 7972805 RAB20 2.212362 5.314486 cancer downregulated 132 7972557 GPR183 0.336149 1.149753 cancer downregulated 133 7955589 NR4A1 2.466932 6.651218 cancer downregulated 134 8097461 CCRN4L 1.379503 3.598936 cancer downregulated 135 8070720 ICOSLG 1.531107 3.198553 cancer downregulated 136 8001317 N4BP1 1.327524 0.790791 cancer upregulated 137 8146550 SDCBP 4.50276 2.731552 cancer upregulated 138 8019877 SMCHD1 1.134906 0.650561 cancer upregulated 139 8061373 GZF1 1.419186 2.453877 cancer downregulated 140 8063382 SNAI1 1.188284 2.400909 cancer downregulated 141 8083494 MME 7.315031 1.208894 cancer upregulated 142 8063115 MMP9 4.024209 1.304142 cancer upregulated 143 7922474 KIAA0040 1.259402 0.759183 cancer upregulated 144 8026564 KLF2 0.795968 0.528515 cancer upregulated 145 7926916 ZEB1 0.284048 0.11094 cancer upregulated 146 8156848 NR4A3 1.050414 2.67113 cancer downregulated 147 8073148 ATF4 1.496953 1.069621 cancer upregulated 148 8000482 XPO6 1.311876 0.731566 cancer upregulated 149 8078014 SLC6 4.293247 2.663884 cancer upregulated 150 7973352 LRP10 1.565493 0.874717 cancer upregulated 151 8052654 PELI 4.641692 2.197016 cancer upregulated 152 7961142 OLR1 1.156079 4.848597 cancer downregulated 153 8026456 CYP4F 5.935402 1.367724 cancer upregulated 154 7922846 FAM129A 2.077295 0.821 cancer upregulated 155 7954711 C12orf35 0.86259 0.488389 cancer upregulated 156 7987192 SLC12A6 2.074418 1.423051 cancer upregulated 157 8019885 SMCHD1 1.219896 0.691931 cancer upregulated 158 8092691 BCL6 9.149487 4.324519 cancer upregulated 159 7998931 ZNF200 1.133831 0.752141 cancer upregulated 160 7945169 TMEM45B 0.885462 0.323788 cancer upregulated 161 8072328 SEC14L2 0.764754 0.403596 cancer upregulated 162 7937335 IFITM1 0.362774 0.115083 cancer upregulated 163 8044049 IL18RAP 0.30373 0.049551 cancer upregulated 164 7946559 GNG10 3.195841 2.039353 cancer upregulated 165 8145244 TNFRSF10C 5.007134 1.784866 cancer upregulated 166 8114010 IRF1 1.714693 0.991787 cancer upregulated 167 7925048 EGLN1 1.783661 1.202735 cancer upregulated 168 7924603 LBR 1.446919 1.020117 cancer upregulated 169 8177951 HCG27 1.293374 0.794496 cancer upregulated 170 7958600 ANKRD13A 1.640972 1.172031 cancer upregulated 171 8075316 OSM 1.762227 3.980639 cancer downregulated 172 8117330 HIST1H3A 0.808308 0.379302 cancer upregulated 173 8090577 MBD4 1.42938 1.048742 cancer upregulated 174 8064438 NSFLIC 2.080207 1.414354 cancer upregulated 175 8127145 ELOVL5 1.251642 0.886912 cancer upregulated 176 8025672 SLC44A2 0.969342 0.555724 cancer upregulated 177 8105778 PIK3R1 0.421185 0.272848 cancer upregulated 178 7974920 SYNE2 0.094911 0.03597 cancer upregulated 179 8086125 TRANK1 0.716401 0.399926 cancer upregulated 180 8026047 JUNB 2.974865 1.490665 cancer upregulated 181 7945944 RHOG 2.197395 1.627514 cancer upregulated 182 8068761 ABCG1 0.985942 0.582396 cancer upregulated 183 8119898 VEGFA 3.47377 7.314255 cancer downregulated 184 7929616 FRAT1 2.715937 1.48299 cancer upregulated 185 8128111 UBE2J1 2.280333 1.458328 cancer upregulated 186 8032127 C19orf2 1.389324 0.85144 cancer upregulated 187 8112220 PDE4D 0.545705 0.908491 cancer downregulated 188 7940287 MS4A1 0.865272 0.300979 cancer upregulated 189 7992811 MMP25 3.585842 1.509232 cancer upregulated 190 7929032 FAS 0.97455 0.580443 cancer upregulated 191 7993035 UBN1 1.892712 1.228282 cancer upregulated 192 8103226 TMEM154 5.549365 3.257222 cancer upregulated 193 8079140 SNRK 0.804865 0.595551 cancer upregulated 194 8116983 CD83 2.156174 4.156219 cancer downregulated 195 8117071 FAM8A1 1.317348 0.866955 cancer upregulated 196 7904465 HIST2H2BA 0.972877 0.687243 cancer upregulated 197 7961365 MANSC1 5.080479 1.822875 cancer upregulated 198 8124280 FAM65B 0.84345 0.566881 cancer upregulated 199 7978595 BAZ1A 1.629444 1.089146 cancer upregulated 200 8066905 ZNFX 1.210468 0.893689 cancer upregulated

TABLE 4 Neutrophil prostate cancer markers (PC-NEUTRO) 1-100 PC- Transcript Control Cancer NEUTRO Cluster ID mean mean Pattern 1 8180410 0.63063484 0.19397697 cancer downregulated 2 8158952 0.6875578 0.24194927 cancer downregulated 3 8138531 0.7122055 0.26055464 cancer downregulated 4 8091806 0.59740742 0.20402938 cancer downregulated 5 8005943 0.55224767 0.18963405 cancer downregulated 6 7956743 0.47917225 0.14307559 cancer downregulated 7 8026440 0.58374878 0.20494112 cancer downregulated 8 8076209 0.39282293 0.08752956 cancer downregulated 9 7942824 0.59451215 0.16395325 cancer downregulated 10 8107470 0.80083176 0.34060884 cancer downregulated 11 8005471 0.58174315 0.16062621 cancer downregulated 12 8025395 0.58587709 0.16124473 cancer downregulated 13 8180297 0.47149462 0.11903531 cancer downregulated 14 7998655 0.53911452 0.22118994 cancer downregulated 15 8013348 0.2186433 0.53383007 cancer downregulated 16 7983843 0.18561995 0.54618191 cancer downregulated 17 8180355 0.19440318 0.59101735 cancer downregulated 18 7920317 0.15604404 0.56532741 cancer downregulated 19 8026868 0.16320999 0.58908022 cancer downregulated 20 8154394 0.20189545 0.74519071 cancer downregulated 21 7986323 0.10306287 0.41147346 cancer downregulated 22 7946812 0.13349395 0.57522988 cancer downregulated 23 8116929 0.18102731 0.55370767 cancer downregulated 24 8030351 0.20773723 0.5350806 cancer downregulated 25 7961022 0.35396993 0.75191636 cancer downregulated 26 8061136 0.2926624 0.79565411 cancer downregulated 27 8085026 0.16197889 0.48683008 cancer downregulated 28 8153903 0.22614154 0.6269282 cancer downregulated 29 8115158 0.20196131 0.53840668 cancer downregulated 30 8101429 0.07289442 0.48628779 cancer downregulated 31 8177003 0.18190856 0.73530108 cancer downregulated 32 8171111 0.18190856 0.73530108 cancer downregulated 33 7900585 0.36257439 0.84416026 cancer downregulated 34 8173513 0.10395144 0.41660967 cancer downregulated 35 7954006 0.35364421 0.7468305 cancer downregulated 36 8024299 0.22346081 0.6228029 cancer downregulated 37 8115234 0.08063857 0.33222302 cancer downregulated 38 8164100 0.0914208 0.38215761 cancer downregulated 39 7948679 0.14102613 0.57794944 cancer downregulated 40 8076511 0.1676643 0.48723858 cancer downregulated 41 8043100 0.25356421 0.74881525 cancer downregulated 42 8174710 0.22337229 0.5091195 cancer downregulated 43 7990965 0.10872074 0.39812056 cancer downregulated 44 7990916 0.10872074 0.39812056 cancer downregulated 45 8051066 0.2069229 0.79589283 cancer downregulated 46 8127526 0.2185427 0.49610551 cancer downregulated 47 7986765 0.16454363 0.52908894 cancer downregulated 48 8034416 0.1365427 0.47170321 cancer downregulated 49 8092457 0.27929283 0.81493697 cancer downregulated 50 7899160 0.13609987 0.61167474 cancer downregulated 51 7954997 0.23835321 0.87499649 cancer downregulated 52 7966534 0.21611199 0.52322977 cancer downregulated 53 8109750 0.06776826 0.36450083 cancer downregulated 54 7968872 0.15717923 0.57732615 cancer downregulated 55 8038086 0.13287674 0.56174531 cancer downregulated 56 8099887 0.18843453 0.44463292 cancer downregulated 57 8171834 0.1922139 0.45416067 cancer downregulated 58 7990898 0.18632151 0.44425134 cancer downregulated 59 8109821 0.20793347 0.69036634 cancer downregulated 60 7973056 0.13506675 0.48508632 cancer downregulated 61 7990949 0.18326745 0.43844761 cancer downregulated 62 8022170 0.21681473 0.52059361 cancer downregulated 63 8116520 0.13806378 0.61288083 cancer downregulated 64 7912956 0.4490642 0.97752282 cancer downregulated 65 7984562 0.21362909 0.5502951 cancer downregulated 66 8009561 0.26753012 0.58406567 cancer downregulated 67 7899957 0.32670929 0.71219915 cancer downregulated 68 7944152 0.15977809 0.61855823 cancer downregulated 69 8050215 0.2762267 0.56213724 cancer downregulated 70 8027778 0.29827452 0.62982603 cancer downregulated 71 7948667 0.11071476 0.53165314 cancer downregulated 72 7966996 0.14171537 0.44740386 cancer downregulated 73 8007441 0.32635716 0.62715565 cancer downregulated 74 8036602 0.17588633 0.64662967 cancer downregulated 75 7965515 0.28983952 0.64953767 cancer downregulated 76 7999520 0.10457296 0.45991055 cancer downregulated 77 8028916 0.2090505 0.60393557 cancer downregulated 78 8172154 0.30916584 0.59966248 cancer downregulated 79 8109222 0.23220579 0.54727725 cancer downregulated 80 8178220 0.19535983 1.32225018 cancer downregulated 81 7917906 0.23715116 0.55094415 cancer downregulated 82 7937476 0.09528914 0.45042024 cancer downregulated 83 8154727 0.20024719 0.65593494 cancer downregulated 84 8043197 0.22640003 0.84722905 cancer downregulated 85 7903010 0.21683704 0.48614067 cancer downregulated 86 8036777 0.10972586 0.34434732 cancer downregulated 87 8125750 0.180311 0.45518696 cancer downregulated 88 8180402 0.36726964 0.68339044 cancer downregulated 89 8117377 0.22475425 0.63874616 cancer downregulated 90 7901038 0.19506976 0.50446547 cancer downregulated 91 7954063 0.16006204 0.40193484 cancer downregulated 92 7933760 0.18249417 0.69607118 cancer downregulated 93 8051204 0.17089002 0.41687142 cancer downregulated 94 8047635 0.19882641 0.48315169 cancer downregulated 95 8151376 0.23801921 0.5412377 cancer downregulated 96 8084488 0.13506115 0.39473505 cancer downregulated 97 8008132 0.18825496 0.56719612 cancer downregulated 98 7905099 0.22074548 0.63249579 cancer downregulated 99 8118594 0.19038692 1.37544631 cancer downregulated 100 7906564 0.37291778 1.44546045 cancer downregulated

TABLE 5 Neutrophil prostate cancer markers (PC-NEUTRO) 101-200 PC- Transcript Control Cancer NEUTRO Cluster ID Gene Name mean mean Pattern 101 8158952 EEF1A1 0.272609 0.69519 cancer downregulated 102 8138531 EEF1A1 0.292444 0.718089 cancer downregulated 103 8091806 RPL23A 0.217459 0.602422 cancer downregulated 104 8026440 RPL23A 0.217383 0.591544 cancer downregulated 105 8005943 RPL23A 0.202168 0.559676 cancer downregulated 106 7956743 RPL14 0.155674 0.482909 cancer downregulated 107 8180410 Unknown 0.205458 0.632606 cancer downregulated 108 8107470 PTMA 0.363448 0.804646 cancer downregulated 109 7961022 PTMA 0.352121 0.758317 cancer downregulated 110 7946812 RPS13 0.144661 0.582832 cancer downregulated 111 8109821 RPL10 0.231264 0.699837 cancer downregulated 112 8180297 Unknown 0.131175 0.478615 cancer downregulated 113 8076209 RPL3 0.099145 0.395548 cancer downregulated 114 7986765 RPL5 0.162151 0.533797 cancer downregulated 115 8061136 PTMA 0.318145 0.802143 cancer downregulated 116 7942824 RPS28 0.1841 0.602922 cancer downregulated 117 8153903 RPL8 0.246933 0.637533 cancer downregulated 118 7954006 PTMA 0.35364 0.756177 cancer downregulated 119 8030351 RPL13A 0.214042 0.54268 cancer downregulated 120 8026868 RPL18A 0.172076 0.597686 cancer downregulated 121 8025395 RPS28 0.181007 0.594891 cancer downregulated 122 8005471 RPS28 0.180152 0.590329 cancer downregulated 123 8116929 RPL15 0.189869 0.556956 cancer downregulated 124 8013348 RPS2 0.226033 0.539682 cancer downregulated 125 7986323 GLTSCR2 0.11244 0.415136 cancer downregulated 126 8076511 RPL5 0.169775 0.49231 cancer downregulated 127 7998655 RPS2 0.230404 0.547071 cancer downregulated 128 8180355 Unknown 0.205643 0.594212 cancer downregulated 129 7901038 RPS8 0.179933 0.505703 cancer downregulated 130 7917906 RPL7 0.235274 0.554955 cancer downregulated 131 8038086 RPL18 0.161233 0.567842 cancer downregulated 132 8109222 RPL7 0.231368 0.547169 cancer downregulated 133 8177003 SLC25A6 0.204081 0.739938 cancer downregulated 134 8171111 SLC25A6 0.204081 0.739938 cancer downregulated 135 8024299 RPS15 0.230076 0.621375 cancer downregulated 136 8164100 RPL35 0.097157 0.39719 cancer downregulated 137 8022170 RPL6 0.209154 0.524477 cancer downregulated 138 8034416 RPL10 0.151345 0.475785 cancer downregulated 139 7948679 EEF1G 0.171641 0.579161 cancer downregulated 140 7983843 TCF12 0.194109 0.549415 cancer downregulated 141 8151376 RPL7 0.23562 0.542258 cancer downregulated 142 8154394 SNAPC3 0.220226 0.744259 cancer downregulated 143 7966534 RPL6 0.213942 0.525259 cancer downregulated 144 8116520 GNB2L1 0.167349 0.619824 cancer downregulated 145 7990965 RPS17 0.115545 0.403805 cancer downregulated 146 7990916 RPS17 0.115545 0.403805 cancer downregulated 147 7920317 ILF2 0.177067 0.563238 cancer downregulated 148 8174710 RPL39 0.221467 0.508284 cancer downregulated 149 7900585 YBX1 0.386508 0.844831 cancer downregulated 150 8171834 RPL 0.183394 0.455141 cancer downregulated 151 8099887 RPL9 0.181173 0.449464 cancer downregulated 152 7990898 RPL 0.178822 0.448604 cancer downregulated 153 8085026 RPL35A 0.182548 0.490163 cancer downregulated 154 8007441 RPL27 0.320568 0.635928 cancer downregulated 155 8047635 RPL12 0.191288 0.486449 cancer downregulated 156 8173513 RPS4X 0.109783 0.420233 cancer downregulated 157 8127526 RPL39 0.217023 0.497392 cancer downregulated 158 7968872 DNAJC15 0.164009 0.578579 cancer downregulated 159 7903010 RPL5 0.207138 0.488715 cancer downregulated 160 7990949 RPL 0.17549 0.441491 cancer downregulated 161 7966996 RPLP0 0.140322 0.450423 cancer downregulated 162 8125750 RPL12 0.173811 0.459102 cancer downregulated 163 7929593 RPL13AP5 0.281785 0.688907 cancer downregulated 164 8043100 TMSB10 0.286022 0.750971 cancer downregulated 165 8172154 RPS2 0.310221 0.602007 cancer downregulated 166 8051066 MPV17 0.23829 0.802767 cancer downregulated 167 8063473 RPL12 0.186844 0.466978 cancer downregulated 168 7933760 CCDC6 0.176523 0.69574 cancer downregulated 169 7899160 CD52 0.151863 0.609583 cancer downregulated 170 7984562 RPLP1 0.213785 0.550247 cancer downregulated 171 7899957 ZMYM4 0.329532 0.718774 cancer downregulated 172 8073799 ATXN10 0.145407 0.485713 cancer downregulated 173 7965515 NDUFA12 0.299008 0.646587 cancer downregulated 174 8101429 PLAC8 0.091296 0.487501 cancer downregulated 175 8115234 ANXA6 0.092768 0.33385 cancer downregulated 176 8022972 RPL7A 0.24819 0.542602 cancer downregulated 177 8118594 HLA-DPB1 0.237858 1.374032 cancer downregulated 178 7939368 TRIM44 0.285441 0.729334 cancer downregulated 179 7905099 VPS45 0.215346 0.629702 cancer downregulated 180 7954063 RPL13AP20 0.160051 0.402787 cancer downregulated 181 8154359 RPL18A 0.267852 0.637549 cancer downregulated 182 8180311 Unknown 0.299804 0.756677 cancer downregulated 183 8097782 RPS3A 0.229725 0.465298 cancer downregulated 184 8178220 HLA-DPB1 0.232773 1.318112 cancer downregulated 185 7973056 APEX1 0.139701 0.483259 cancer downregulated 186 8115158 RPS14 0.234508 0.539576 cancer downregulated 187 8150872 RPS20 0.165436 0.397082 cancer downregulated 188 8179519 HLA-DPB1 0.217481 1.420595 cancer downregulated 189 7912956 RCC2 0.486488 0.984242 cancer downregulated 190 8092457 ALG3 0.295813 0.806165 cancer downregulated 191 8109750 RPLP0 0.083731 0.368508 cancer downregulated 192 8009561 RPL38 0.291106 0.596993 cancer downregulated 193 8117377 HIST1H1E 0.262937 0.643168 cancer downregulated 194 8108954 TCERG1 0.226147 0.589687 cancer downregulated 195 8028916 SNRPA 0.217766 0.60521 cancer downregulated 196 7996947 CYB5B 0.258857 0.497964 cancer downregulated 197 7971134 C13orf2 0.267679 0.590453 cancer downregulated 198 7944152 IL10RA 0.185371 0.619532 cancer downregulated 199 7999520 RSL1D1 0.109754 0.454291 cancer downregulated 200 7993349 NPIP 0.286955 0.524779 cancer downregulated

Example 4: Detecting Head and Neck Cancer

After identifying markers useful for detecting prostate cancer, PC-MACRO 1-4 were tested for their ability to also diagnose head and neck cancer. Specifically, the genetic signature S was calculated for each patient as a weighted average of the genes in the signature, wherein S >0 implies cancer and S<0 implies no cancer (healthy). The prostate cancer markers accurately segregated patients into “healthy” and “cancer” groups (FIG. 4 ). The PC-NEUTRO 1-11 markers also were tested for their ability to diagnose head and neck cancer by calculating S for each patient. In this experiment, only a single “healthy” patient was misdiagnosed (FIG. 6 ).

Example 5: Additional Validation

Additional validation is performed by validating the gene signature on a new data set of ˜50 prostate cancer cases and 50 controls. Final validation is performed by estimating the sensitivity and specificity of the final gene signature on a large sample. For example, 195 cases and 195 controls can be used to estimate a sensitivity/specificity of at least 97.5% with a 95% margin of error no more than 5%. A challenge in designing a final validation study is that although cancer patients are pure, controls may have up to 20% false negatives. A statistical issue is that, while estimating sensitivity is not a problem, specificity has an upper bound of 80%. The solution is to purify the control set of patients. A purification method uses secondary screening of all controls, wherein three methylated gene marker tests are used to purify the control test set:

-   -   1. GST-Pi (sensitivity=95%, specificity=85%)     -   2. RAR-2b (sensitivity=95%, specificity=48%)     -   3. APC (sensitivity=95%, specificity=50%)         in men with two serial negative biopsies. A second purification         method is depicted in FIG. 8 , and a comparison of purification         methods is shown in FIG. 9 . 

1-81. (canceled)
 82. A method for measuring the level of a marker in a sample from a subject, the method comprising the steps of: a) measuring the levels of two to ten markers selected from the group consisting of ALPL, PI3, CXCR2, GPR97, HBEGF, EREG, MMP9, TNFRSF10C, MMP25, and MS4A1 in a population of the subject's macrophage cells; b) measuring the levels of the two to ten selected markers in a population of the subject's non-phagocytic cells; wherein the measuring the levels of the two to ten selected markers occurs prior to the subject receiving treatment for prostate cancer.
 83. The method of claim 82, wherein the measuring the levels of the two to ten selected markers comprises measuring gene expression levels.
 84. The method of claim 83, wherein the gene expression levels are measured by a sequencing technique selected from the group consisting of direct sequencing, RNA sequencing, whole transcriptome shotgun sequencing, random shotgun sequencing, Sanger dideoxy termination sequencing, whole-genome sequencing, sequencing by hybridization, pyrosequencing, capillary electrophoresis, gel electrophoresis, duplex sequencing, cycle sequencing, single-base extension sequencing, solid-phase sequencing, high-throughput sequencing, massively parallel signature sequencing, emulsion PCR, sequencing by reversible dye terminator, paired-end sequencing, near-term sequencing, exonuclease sequencing, sequencing by ligation, short-read sequencing, single-molecule sequencing, sequencing-by-synthesis, real-time sequencing, reverse-terminator sequencing, nanopore sequencing, 454 sequencing, Solexa Genome Analyzer sequencing, SOLiD® sequencing, MS-PET sequencing, mass spectrometry, and a combination thereof.
 85. The method of claim 83, wherein the gene expression levels are measured by polymerase chain reaction (PCR) analysis, sequencing analysis, electrophoretic analysis, restriction fragment length polymorphism (RFLP) analysis, Northern blot analysis, quantitative PCR, reverse-transcriptase-PCR analysis (RT-PCR), allele specific oligonucleotide hybridization analysis, comparative genomic hybridization, heteroduplex mobility assay (HMA), single strand conformational polymorphism (SSCP), denaturing gradient gel electrophisis (DGGE), RNAase mismatch analysis, mass spectrometry, tandem mass spectrometry, matrix assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry, electrospray ionization (ESI) mass spectrometry, surface-enhanced laser desorption/ionization-time of flight (SELDI-TOF) mass spectrometry, quadrupole time of flight (Q-TOF) mass spectrometry, atmospheric pressure photoionization mass spectrometry (APPI-MS), Fourier transform mass spectrometry (FTMS), matrix-assisted laser desorption/ionization-Fourier transform-ion cyclotron resonance (MALDI-FT-ICR) mass spectrometry, secondary ion mass spectrometry (SIMS), surface plasmon resonance, Southern blot analysis, in situ hybridization, fluorescence in situ hybridization (FISH), chromogenic in situ hybridization (CISH), immunohistochemistry (IHC), microarray, comparative genomic hybridization, karyotyping, multiplex ligation-dependent probe amplification (MLPA), Quantitative Multiplex PCR of Short Fluorescent Fragments (QMPSF), microscopy, methylation specific PCR (MSP) assay, Hpaii tiny fragment Enrichment by Ligation-mediated PCR (HELP) assay, radioactive acetate labeling assays, colorimetric DNA acetylation assay, chromatin immunoprecipitation combined with microarray (ChiP-on-chip) assay, restriction landmark genomic scanning, Methylated DNA immunoprecipitation (MeDIP), molecular break light assay for DNA adenine methyltransferase activity, chromatographic separation, methylation-sensitive restriction enzyme analysis, bisulfite-driven conversion of non-methylated cytosine to uracil, methyl-binding PCR analysis, or a combination thereof.
 86. The method of claim 83, wherein the gene expression levels are measured by an amplification assay or a sequencing assay.
 87. The method of claim 82, wherein the non-phagocytic cells are T cells, B cells, null cells, basophils, or mixtures thereof.
 88. The method of claim 82, further comprising measuring at least one standard parameter associated with prostate cancer.
 89. The method of claim 88, wherein the standard parameter is selected from the group consisting of tumor stage, tumor grade, tumor size, tumor visual characteristics, tumor growth, tumor thickness, tumor progression, tumor metastasis, tumor distribution within the body, odor, molecular pathology, genomics, or tumor angiograms.
 90. The method of claim 82, wherein measuring the levels of the two to ten selected markers comprises measuring the levels at a first time point and measuring the levels at a second time point, wherein at least the first time point occurs prior to the subject receiving treatment for prostate cancer.
 91. The method of claim 90, wherein the second time point occurs after the subject receives treatment for prostate cancer. 